{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:12:27Z","timestamp":1787242347405,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Intravesical therapy following transurethral resection of bladder tumor (TURBT) remains the standard of care for non-muscle invasive bladder cancer (NMIBC). However, the global shortage of Bacillus Calmette-Gu\u00e9rin (BCG) and its notable side effect profile have driven interest in alternative agents such as gemcitabine and hyperthermic intravesical chemotherapy (HIVEC), both of which have shown promising results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods:<\/jats:title>\n                    <jats:p>\n                      A total of 100 consenting patients with intermediate- and high-risk NMIBC, as per EAU 2020 risk stratification, were enrolled at a single institution between January 2021 and July 2022. Patients were electronically randomized in a 2:1:1 ratio into three groups: gemcitabine (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200950), HIVEC (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200925), and BCG (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200925). Follow-up included cystoscopy and urine cytology every 3\u2009months. Adverse events were assessed and graded using the Modified Clavien-Dindo Classification System.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At 12\u2009months, recurrence-free survival (RFS) was 94% in the gemcitabine group, 84% in the HIVEC group, and 92% in the BCG group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.675, intention-to-treat analysis). No cases of grade or stage progression were observed. Most recurrences (88.9%) occurred in the high-risk subgroup. Treatment-related side effects were significantly more frequent in the BCG group, while gemcitabine was the most well-tolerated during both induction and maintenance phases. The most common adverse events included lower urinary tract symptoms (LUTS), dysuria, and urinary tract infections (UTIs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Preliminary findings indicate that intravesical gemcitabine is non-inferior to BCG and HIVEC in terms of short-term efficacy, with a significantly better safety and tolerability profile. These results position gemcitabine as a viable alternative in the management of NMIBC. However, the study\u2019s limited sample size and short follow-up period necessitate larger, long-term studies to validate these outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03915603251388204","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T10:05:46Z","timestamp":1762855546000},"page":"170-176","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A randomized study comparing outcomes of intravesical Gemcitabine, Mitomycin C (as hyperthermic intravesical chemotherapy-HIVEC) and Bacillus-Calmette Guerin in intermediate and high-risk non-muscle invasive bladder cancer"],"prefix":"10.1177","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-2834","authenticated-orcid":false,"given":"Shreyas Nellamkuziyil","family":"Michael","sequence":"first","affiliation":[{"name":"Department of Urology and Renal Transplant, Father Muller Medical College Hospital, Mangaluru, Dakshina Kannada, Karnataka, India"},{"name":"Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences &amp; Dr. Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Makkar","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences &amp; Dr. Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supreeth","family":"Nagaraju","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences &amp; Dr. Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences &amp; Dr. Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemant Kumar","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences &amp; 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