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Young age and adequate BCG are key factors for optimal BCG treatment efficacy in non-muscle-invasive bladder cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年9月27日

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  • Kang Liu,
  • Rossella Nicoletti,
  • Hongda Zhao,
  • Xuan Chen,
  • Hongwei Wu,
  • Chi-Ho Leung,
  • David D’Andrea,
  • Ekaterina Laukhtina,
  • Francesco Soria,
  • Andrea Gallioli,
  • Marcelo Langer Wroclawski,
  • Daniele Castellani,
  • Vineet Gauhar,
  • Juan Gomez Rivas,
  • Dmitry Enikeev,
  • Paolo Gontero,
  • Shahrokh F. Shariat,
  • Peter Ka-Fung Chiu,
  • Chi-Fai Ng,
  • Jeremy Yuen-Chun Teoh

摘要

Objective

To investigate the impact of ageing on survival outcomes in Bacillus Calmette–Guérin (BCG) treated non-muscle invasive bladder cancer (NMIBC) patients and its synergy with adequate BCG treatment.

Method

Patients with NMIBC who received BCG treatment from 2001 to 2020 were divided into group 1 (< = 70 years) and group 2 (> 70 years). Overall Survival (OS), Cancer-Specific Survival (CSS), Recurrence-Free Survival (RFS), and Progression-Free Survival (PFS) were analyzed using the Kaplan–Meier method. Multivariable Cox regression analysis was used to adjust potential confounding factors and to estimate Hazard Ratio (HR) and 95% Confidence Interval (CI). Subgroup analysis was performed according to adequate versus inadequate BCG treatment.

Results

Overall, 2602 NMIBC patients were included: 1051 (40.4%) and 1551 (59.6%) in groups 1 and 2, respectively. At median follow-up of 11.0 years, group 1 (< = 70 years) was associated with better OS, CSS, and RFS, but not PFS as compared to group 2 (> 70 years). At subgroup analysis, patients in group 1 treated with adequate BCG showed better OS, CSS, RFS, and PFS as compared with inadequate BCG treatment in group 2, while patients in group 2 receiving adequate BCG treatment had 41% less progression than those treated with inadequate BCG from the same group.

Conclusions

Being younger (< = 70 years) was associated with better OS, CSS, and RFS, but not PFS. Older patients (> 70 years) who received adequate BCG treatment had similar PFS as those younger with adequate BCG treatment.