{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:18:46Z","timestamp":1792703926790,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T00:00:00Z","timestamp":1724544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify the oncological risks of bladder\u2010sparing therapy (BST) in patients with Bacillus Calmette\u2013Gu\u00e9rin (BCG)\u2010unresponsive non\u2010muscle\u2010invasive bladder cancer (NMIBC) compared to upfront radical cystectomy (RC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Pre\u2010specified data elements were collected from retrospective cohorts of patients with BCG\u2010unresponsive NMIBC from 10 international sites. After Institutional Review Board approval, patients were included if they had BCG\u2010unresponsive NMIBC meeting United States Food and Drug Administration criteria. Oncological outcomes were collected following upfront RC or BST. BST regimens included re\u2010resection or surveillance only, repeat BCG, intravesical chemotherapy, systemic immunotherapy, and clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 578 patients, 28% underwent upfront RC and 72% received BST. The median (interquartile range) follow\u2010up was 50\u2009(20\u201369)\u2009months. There were no statistically significant differences in metastasis\u2010free survival, cancer\u2010specific survival, or overall survival between treatment groups. In the BST group, high\u2010grade recurrence rates were 37% and 52% at 12 and 24\u2009months and progression to MIBC was observed in 7% and 13% at 12 and 24\u2009months, respectively. RC was performed in 31.7% in the BST group and nodal disease was found in 13% compared with 4% in upfront RC (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.030).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a selected cohort of patients, initial BST offers comparable survival outcomes to upfront RC in the intermediate term. Rates of recurrence and progression increase over time especially in patients treated with additional lines of BST.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16509","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T01:04:26Z","timestamp":1724634266000},"page":"260-268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Long\u2010term outcomes of bladder\u2010sparing therapy vs radical cystectomy in BCG\u2010unresponsive non\u2010muscle\u2010invasive bladder cancer"],"prefix":"10.1111","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2190-7309","authenticated-orcid":false,"given":"Jacob I.","family":"Taylor","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center  Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish 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Shen","family":"Tan","sequence":"additional","affiliation":[{"name":"University of Texas MD Anderson Cancer Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9991-4301","authenticated-orcid":false,"given":"Ian","family":"McElree","sequence":"additional","affiliation":[{"name":"University of Iowa  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Facundo","family":"Davaro","sequence":"additional","affiliation":[{"name":"Moffit Cancer Center  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendrick","family":"Yim","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Harrington","sequence":"additional","affiliation":[{"name":"Penn State Health  Hershey PA 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