{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T09:50:40Z","timestamp":1777542640965,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2008,6,9]],"date-time":"2008-06-09T00:00:00Z","timestamp":1212969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2008,8,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>Intravesical bacillus Calmette\u2010Gu\u00e9rin (BCG) immunotherapy is effective in preventing recurrence and progression in nonmuscle\u2010invasive bladder cancer but the dosing schedule and duration of treatment remain empirical. The outcome of BCG therapy was prospectively evaluated on patients according to the number of maintenance cycles received.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>Between 1997 and 2002, 111 patients with nonmuscle\u2010invasive bladder cancer at high risk of recurrence and progression underwent transurethral resection followed by intravesical instillations of BCG. After an induction treatment of 6 weekly instillations, patients were scheduled to receive a 3\u2010weekly maintenance treatment at the 3rd, 6th, 12th, 18th, 24th, 30th, and 36th month. At each visit a clinical assessment was obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>Over a median clinical follow\u2010up of 31 months, 43% of patients experienced recurrence and 8.1% progressed to muscle\u2010invasive disease or metastasis. Only 1 patient received all scheduled instillations. Patients who received at least 3 maintenance BCG cycles had a significantly reduced risk of recurrence (hazard ratio [HR] = 0.23, <jats:italic>P<\/jats:italic> = .0064, adjusted for gender, age, and stage) compared with patients receiving only induction BCG. Twelve months after the end of maintenance, the estimated Kaplan\u2010Meier recurrence\u2010free survival was 89% for patients who received at least 3 maintenance BCG cycles, 67% for those who received 2 maintenance BCG cycles, and 41% for those who received only the induction BCG or 1 maintenance cycle (<jats:italic>P<\/jats:italic> = .0003).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>The results of this study suggest that a minimum of 3 cycles of maintenance BCG is required to significantly reduce the recurrence rate. It also suggests that more cycles may result in further improvements but the benefits may be outweighed by increasing side effects in some patients. Cancer 2008. \u00a9 2008 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.23627","type":"journal-article","created":{"date-parts":[[2008,6,9]],"date-time":"2008-06-09T18:16:36Z","timestamp":1213035396000},"page":"710-716","source":"Crossref","is-referenced-by-count":33,"title":["Maintenance bacillus Calmette\u2010Gu\u00e9rin in high\u2010risk nonmuscle\u2010invasive bladder cancer"],"prefix":"10.1002","volume":"113","author":[{"given":"Marc","family":"Decobert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9l\u00e8ne","family":"LaRue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Harel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Fradet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Lacombe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,6,9]]},"reference":[{"key":"e_1_2_6_2_2","volume-title":"Canadian Cancer Statistics 2006","author":"McLaughlin JR","year":"2006"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1067\/mcn.2001.117539"},{"key":"e_1_2_6_4_2","first-page":"499","article-title":"Carcinoma in situ","volume":"19","author":"Lamm DL","year":"1992","journal-title":"Urol Clin North Am."},{"key":"e_1_2_6_5_2","first-page":"27","article-title":"[T1 bladder tumors: value of a second endoscopic resection.]","volume":"12","author":"Rigaud J","year":"2002","journal-title":"Prog Urol."},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2006.06145.x"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)66226-8"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1007199932271"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199110243251703"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)64273-5"},{"issue":"1","key":"e_1_2_6_11_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1159\/000475201","article-title":"BCG in perspective: advances in the treatment of superficial bladder cancer","volume":"27","author":"Lamm DL","year":"1995","journal-title":"Eur Urol."},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2005.12.014"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)38242-3"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67707-5"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19971101)80:9<1803::AID-CNCR16>3.0.CO;2-9"},{"key":"e_1_2_6_16_2","first-page":"519","article-title":"The methodologic dilemma in retrospectively correlating the amount of chemotherapy received in adjuvant therapy protocols with disease\u2010free survival","volume":"67","author":"Redmond C","year":"1983","journal-title":"Cancer Treat Rep."},{"key":"e_1_2_6_17_2","volume-title":"Modelling Survival Data in Medical Research","author":"Collett D","year":"2003"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2003.04764.x"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0302-2838(03)00357-9"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(00)01117-1"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.23627","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.23627","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T15:38:16Z","timestamp":1760283496000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.23627"}},"subtitle":["How much is enough?"],"short-title":[],"issued":{"date-parts":[[2008,6,9]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2008,8,15]]}},"alternative-id":["10.1002\/cncr.23627"],"URL":"https:\/\/doi.org\/10.1002\/cncr.23627","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,6,9]]}}}