{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:32:31Z","timestamp":1776472351976,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"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":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate which subgroups of patients with intermediate\u2010risk non\u2010muscle\u2010invasive bladder cancer (IR\u2010NMIBC) benefit from maintenance therapy based on the International Bladder Cancer Group (IBCG) risk stratification, as the role of a maintenance course in patients with IR\u2010NMIBC is debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We relied on a prospectively maintained database of patients with IR\u2010NMIBC who received intravesical chemotherapy or Bacillus Calmette\u2013Gu\u00e9rin (BCG) (2010\u20132023). Patients were stratified according the IBCG prognostic algorithm (no, one to two, and three or more risk factors). All patients received at least six induction instillations after index transurethral resection of bladder tumour. We used 3\u2010month landmark stacked cumulative incidence and multivariable Cox regression models to assess the benefit from a maintenance course in terms of risk of recurrence and progression according to the IBCG risk groups stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 464 patients, 205 (44%) received BCG treatment and 259 (56%) received intravesical chemotherapy. The median (interquartile range) number of maintenance instillations was 9\u2009(5\u201311). Over a median follow\u2010up of 57\u2009months, 139 (30%) patients had a recurrence. Patients with no IBCG risk factors had a similar risk of 5\u2010year disease recurrence according to treatment duration (7.7% vs 7.3%; hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.49\u20131.37, for induction only vs induction plus maintenance, respectively), whereas patients with one to two (5\u2010year risk: 16% vs 13%; HR 0.65, 95% CI 0.48\u20130.82) or three or more IBCG risk factors (5\u2010year risk: 21% vs 17%; HR 0.48, 95% CI 0.25\u20130.85) were associated with lower hazards of recurrence if treated with an induction plus maintenance course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The IBCG algorithm effectively stratifies patients with IR\u2010NMIBC by recurrence risk. In this observational cohort, maintenance therapy was associated with lower recurrence rates in patients with one to two or three or more IBCG risk factors, but not in those with no risk factors. These findings suggest that the IBCG stratification may inform risk\u2010adapted treatment decisions in patients with IR\u2010NMIBC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16905","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T16:30:10Z","timestamp":1755880210000},"page":"201-208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The value of maintenance therapy in intermediate\u2010risk non\u2010muscle\u2010invasive bladder cancer"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8050-9388","authenticated-orcid":false,"given":"Paolo","family":"Zaurito","sequence":"first","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6126-9889","authenticated-orcid":false,"given":"Pietro","family":"Scilipoti","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Longoni","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Viti","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0494-7839","authenticated-orcid":false,"given":"Mario","family":"de Angelis","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9363-682X","authenticated-orcid":false,"given":"Giovanni","family":"Tremolada","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9523-3400","authenticated-orcid":false,"given":"Leonardo","family":"Quarta","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Cosenza","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Occhi","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Galdieri","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Disabato","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Brancaccio","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giusy","family":"Burgio","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Necchi","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Oncology IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1914-0743","authenticated-orcid":false,"given":"Maurizio","family":"Colecchia","sequence":"additional","affiliation":[{"name":"Department of Pathology IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-7165","authenticated-orcid":false,"given":"Andrea","family":"Salonia","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7267-4181","authenticated-orcid":false,"given":"Francesco","family":"Montorsi","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Briganti","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Moschini","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.06.045"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.12.031"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.010"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.12.033"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.02.2573"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2022.05.005"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.06.004"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2024.06.026"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.06.005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.02.063"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.12.002"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.07.027"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.10.039"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(96)00075-X"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.1.191"},{"key":"e_1_2_9_17_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2022"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003639"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2023.03.025"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/21681805.2020.1782978"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-05417-z"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.04.066"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.05.050"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2004.05.003"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.16905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:03:54Z","timestamp":1765357434000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.16905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/bju.16905"],"URL":"https:\/\/doi.org\/10.1111\/bju.16905","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,22]]},"assertion":[{"value":"2025-08-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}