{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:41:27Z","timestamp":1775742087029,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"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":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To assess whether bacillus Calmette\u2013Gu\u00e9rin (BCG) responsiveness after initiation of an adequate BCG treatment (at least five of six instillations of induction and at least two of three instillations of maintenance) impacts oncological outcomes in patients with carcinoma\n                      <jats:italic>in\u2009situ<\/jats:italic>\n                      (CIS) of the bladder treated with BCG immunotherapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Data were available for 193 patients with bladder CIS with or without associated cTa\/cT1 disease who received an adequate BCG treatment between 2008 and 2015. Bladder biopsies were taken at 6\u2009months and patients were then stratified as either BCG responsive (negative biopsies) or BCG unresponsive (positive biopsies). Inverse probability weighting (IPW)\u2010adjusted Kaplan\u2013Meier and IPW\u2010adjusted Cox regression were performed to compare progression\u2010free survival (PFS), radical cystectomy\u2010free survival (RCFS), overall survival OS, and cancer\u2010specific survival (CSS) in the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Limitations<\/jats:title>\n                    <jats:p>\n                      Comparing the BCG\u2010responsive and BCG\u2010unresponsive groups, IPW\u2010adjusted Kaplan\u2013Meier analysis revealed, respectively, a median (interquartile range) of PFS of 9\u2009(5\u201315) vs 48.5\u2009(28\u201377)\u2009months (\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u20090.001), a RCFS of 11\u2009(9\u201315) vs 49\u2009(24\u201376)\u2009months (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and a CSS of 25\u2009(13\u201360) vs 109\u2009(78\u2013307)\u2009months (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004). On IPW\u2010adjusted Cox regression analysis, BCG\u2010unresponsive patients had a worse PFS (hazard ratio [HR] 3.40, 95% confidence interval [CI] 1.59\u20137.27), RCFS (HR 3.52, 95% CI 1.77\u20137), and CSS (HR 4.42, 95% CI 1.95\u201310.01). We found no significant differences for OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Using an IPW method we found that lack of response after initiation of an adequate BCG treatment has prognostic implications beyond identification of complete response in patients with CIS. BCG\u2010unresponsive patients, satisfying the novel definition of BCG unresponsive, showed a poor PFS, RCFS, and CSS. In this setting, the patients should be counselled regarding RC as a first option or enrolled in a clinical trial if they refuse RC or are unfit for surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15567","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T15:01:16Z","timestamp":1628607676000},"page":"542-550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Contemporary outcomes of bladder carcinoma\n                    <i>in\u2009situ<\/i>\n                    treated with an adequate bacille Calmette\u2013Gu\u00e9rin immunotherapy"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4176-8174","authenticated-orcid":false,"given":"Jos\u00e9 Daniel","family":"Subiela","sequence":"first","affiliation":[{"name":"Urooncology Unit Department of Urology, Fundaci\u00f3 Puigvert Department of Surgery Universitat Aut\u00f2noma de Barcelona Barcelona Spain"},{"name":"Oncological and Functional Bladder Pathology Unit Department of Urology Hospital Universitario Ram\u00f3n y Cajal Universidad de Alcal\u00e1 Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6668-4423","authenticated-orcid":false,"given":"\u00d3scar","family":"Rodr\u00edguez Faba","sequence":"additional","affiliation":[{"name":"Urooncology Unit Department of Urology, Fundaci\u00f3 Puigvert Department of Surgery Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00falia","family":"Aumatell","sequence":"additional","affiliation":[{"name":"Urooncology Unit Department of Urology, Fundaci\u00f3 Puigvert Department of Surgery Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Urooncology Unit Department of Urology, Fundaci\u00f3 Puigvert Department of Surgery Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asier","family":"Mercad\u00e9","sequence":"additional","affiliation":[{"name":"Urooncology Unit Department of Urology, Fundaci\u00f3 Puigvert Department of Surgery Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Bala\u00f1\u00e0","sequence":"additional","affiliation":[{"name":"Urooncology Unit Department of Urology, Fundaci\u00f3 Puigvert Department of Surgery Universitat Aut\u00f2noma de Barcelona Barcelona 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