{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T15:25:04Z","timestamp":1775748304885,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of upper tract urothelial carcinoma (UTUC) on bacillus Calmette\u2010Guerin (BCG) response and progression in patients with non\u2010muscle\u2010invasive bladder cancer (NMIBC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      We performed an institutional review board\u2010approved review of patients with NMIBC treated with adequate intravesical BCG, as defined by the US Food and Drug Administration, at our institution between 2000 and 2018. Patients were stratified by presence of any UTUC and time of UTUC diagnosis (preceding vs synchronous to NMIBC diagnosis or metachronous disease after NMIBC diagnosis). Descriptive statistics were used to summarize the data overall and by groups, and\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests or Wilcoxon\u2019s rank sum tests and Pearson\u2019s chi\u2010squared or Fisher\u2019s exact tests were used to analyse continuous and categorical data, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 541 patients with NMIBC treated with adequate BCG, 59 (10.9 %) were diagnosed with UTUC. Of these, 34 had a history of UTUC prior to NMIBC (UTUC\u2010P; median [interquartile range {IQR}] 13.1\u00a0[7.4\u201327.6]\u00a0months prior), while 25 developed UTUC after diagnosis of NMIBC (six synchronous and 19 metachronous; median [IQR] 12.1 [1.7\u201328.1]\u00a0months after). Compared to the non\u2010UTUC group, patients with UTUC\u2010P were more likely to exhibit Tis without papillary tumour in the bladder (20.6% vs 5.0%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), but were less likely to have T1 disease on index transurethral resection (8.8% vs 49.4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Patients with UTUC\u2010P developed more recurrences (55.9% vs 34.0%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.010), any stage\/grade progression (23.5% vs 9.8%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.012) and progression to muscle\u2010invasive or metastatic disease (17.6% vs 6.4%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.014). The presence of high\u2010grade UTUC\u2010P compared to low\u2010grade UTUC\u2010P was associated with increased NMIBC recurrence (68.2% vs 25.0%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.049). There was no significant difference in rates of recurrence or progression based on timing of UTUC with respect to the index bladder tumour, although this analysis was limited by small numbers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Presence of UTUC prior to a diagnosis of NMIBC was associated with an almost twofold increased recurrence and progression rates after adequate BCG therapy. This should be considered when counselling patients and designing cohorts for clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15344","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T01:26:38Z","timestamp":1611365198000},"page":"568-574","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of upper tract urothelial carcinoma on response to BCG in patients with non\u2010muscle\u2010invasive bladder cancer"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-7763","authenticated-orcid":false,"given":"Kelly K.","family":"Bree","sequence":"first","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick J.","family":"Hensley","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5111-6914","authenticated-orcid":false,"given":"Nathan A.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Matulay","sequence":"additional","affiliation":[{"name":"Department of Urology Levine Cancer Institute Atrium Health Charlotte NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1274-7200","authenticated-orcid":false,"given":"Roger","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology Moffitt Cancer Center Tampa FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graciela M.","family":"Nogueras Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neema","family":"Navai","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert Barton","family":"Grossman","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1638-1445","authenticated-orcid":false,"given":"Surena F.","family":"Matin","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin P. N.","family":"Dinney","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish M.","family":"Kamat","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-0143(21)00411-0"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.06.045"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.07.016"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.06.045"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.06.044"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4111\/kju.2014.55.7.453"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000129541.23460.48"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.4070"},{"key":"e_1_2_7_11_1","unstructured":"U.S. Food and Drug Administration.BCG unresponsive nonmuscle invasive bladder cancer: developing drugs and biologics for treatment guidance for industry. Available at:https:\/\/www.fda.gov\/ucm\/groups\/fdagov\u2010public\/@fdagov\u2010drugs\u2010gen\/documents\/document\/ucm529600.pdf. 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