{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T22:36:00Z","timestamp":1787438160987,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare survival outcomes between Japanese patients receiving radical cystectomy (RC) and intravesical Bacillus Calmette\u2013Gu\u00e9rin (BCG) for high\u2010risk non\u2013muscle\u2010invasive bladder cancer (HR\u2010NMIBC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted within the Japanese Urological Oncology Group (JUOG) framework using two nationwide, multi\u2010institutional databases: JUOG\u2010UC\u20102021\u2010RC, comprising 2674 patients with bladder cancer who underwent RC, and JUOG\u2010UC\u20101901\u2010BCG, comprising 3226 patients who received intravesical BCG. Patients were classified according to the Japanese Urological Association guideline (version 2023) risk stratification model into three cohorts: BCG\u2010na\u00efve standard HR\u2010NMIBC (without aggressive factors), BCG\u2010na\u00efve highest\u2010risk NMIBC (an aggressive subgroup), and BCG\u2010unresponsive NMIBC. Metastasis\u2010free survival (MFS) and overall survival (OS) were compared between the two interventions. Propensity score matching was applied to create well\u2010balanced groups (BCG vs RC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the adjusted BCG\u2010na\u00efve standard HR\u2010NMIBC subcohort, both MFS and OS were longer in the BCG\u2010treated group than in the RC group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027, respectively). However, no significant differences in MFS or OS were observed in the adjusted BCG\u2010na\u00efve highest\u2010risk NMIBC subcohort (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.20 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.47, respectively). In the adjusted BCG\u2010unresponsive NMIBC cohort, no differences in MFS or OS were detected (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.76 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.35, respectively), although long\u2010term survival outcomes appeared better in the salvage RC group than in the BCG rechallenge group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings demonstrated that the RC group had worse outcomes than the BCG group in the BCG\u2010na\u00efve standard HR\u2010NMIBC subcohort but not in the highest\u2010risk or BCG\u2010unresponsive cohorts. Accumulating evidence is essential to guide physicians in counseling patients with HR\u2010NMIBC and BCG\u2010unresponsive NMIBC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registry and the Registration No. of the Study\/Trial<\/jats:title>\n                    <jats:p>The authors have nothing to report.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70314","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T01:20:46Z","timestamp":1765588846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real\u2010World Comparison of Survival Outcomes Between Radical Cystectomy and Intravesical Bacillus Calmette\u2010Gu\u00e9rin (\n                    <scp>BCG<\/scp>\n                    ) Therapy in\n                    <scp>BCG<\/scp>\n                    \u2010Na\u00efve or \u2010Unresponsive Non\u2013Muscle\u2010Invasive Bladder Cancer"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-7356","authenticated-orcid":false,"given":"Makito","family":"Miyake","sequence":"first","affiliation":[{"name":"Department of Urology Nara Medical University  Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Urology Nara Medical University  Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3243-499X","authenticated-orcid":false,"given":"Rikiya","family":"Taoka","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine Kagawa University  Kagawa 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