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- Title
Single immediate instillation of chemotherapy is associated with decreased recurrence and progression in patients with high‐risk non‐muscle‐invasive bladder cancer who receive adjuvant induction bacillus Calmette‐Guérin therapy
- Authors
Fujita, Naoki; Hatakeyama, Shingo; Momota, Masaki; Narita, Takuma; Tobisawa, Yuki; Yoneyama, Tohru; Yamamoto, Hayato; Ito, Hiroyuki; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Yoshikawa, Kazuaki; Ohyama, Chikara
- Abstract
Objectives: To investigate whether a single intravesical instillation of chemotherapy is associated with improved oncological outcomes in patients with high‐risk non‐muscle‐invasive bladder cancer who receive adjuvant induction bacillus Calmette‐Guérin therapy. Methods: This multi‐institutional retrospective study included 205 patients with high‐risk non‐muscle‐invasive bladder cancer who received adjuvant induction bacillus Calmette‐Guérin therapy. Patients were divided into two groups: those who received the combined therapy of a single instillation of chemotherapy plus subsequent adjuvant induction bacillus Calmette‐Guérin therapy (combined therapy group), and those who received adjuvant induction bacillus Calmette‐Guérin therapy alone (bacillus Calmette‐Guérin monotherapy group). Multivariable analyses using the inverse probability of treatment weighting method and Fine‐Gray competing risk regression models were performed to evaluate the impact of a single instillation of chemotherapy on intravesical recurrence‐free survival and muscle‐invasive bladder cancer‐free survival. Results: Among the 205 patients, 130 (63%) and 75 (37%) were classified as the combined therapy and bacillus Calmette‐Guérin monotherapy groups, respectively. Multivariable analyses using the inverse probability of treatment weighting method showed that a single instillation of chemotherapy was significantly associated with longer intravesical recurrence‐free survival (hazard ratio 0.279; P < 0.001) and muscle‐invasive bladder cancer‐free survival (hazard ratio 0.078; P < 0.001). Fine‐Gray competing risk regression model revealed that a single instillation of chemotherapy was associated with a significantly lower probability of intravesical recurrence and muscle‐invasive bladder cancer progression, with an adjusted subdistribution hazard ratio of 0.477 (P = 0.008) and 0.261 (P = 0.043), respectively. Conclusion: A single intravesical instillation of chemotherapy may be a potential treatment option in patients with high‐risk non‐muscle‐invasive bladder cancer who receive adjuvant induction bacillus Calmette‐Guérin therapy.
- Subjects
CANCER invasiveness; BLADDER cancer; INTRAVESICAL administration; DISEASE relapse; CANCER chemotherapy
- Publication
International Journal of Urology, 2022, Vol 29, Issue 8, p867
- ISSN
0919-8172
- Publication type
Article
- DOI
10.1111/iju.14926