{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:20:51Z","timestamp":1788409251815,"version":"build-2803163510"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cancer"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To explore possible solutions to overcome chronic Bacillus Calmette\u2013Gu\u00e9rin (BCG) shortage affecting seriously the management of non-muscle invasive bladder cancer (NMIBC) in Europe and throughout the world, we investigated whether non-maintenance eight-dose induction BCG (iBCG) was comparable to six-dose iBCG plus maintenance BCG (mBCG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study evaluated 2669 patients with high- or highest-risk NMIBC who treated with iBCG with or without mBCG during 2000\u20132019. The patients were classified into five groups according to treatment pattern: 874 (33%) received non-maintenance six-dose iBCG (Group A), 405 (15%) received six-dose iBCG plus mBCG (Group B), 1189 (44%) received non-maintenance seven\u2212\/eight-dose iBCG (Group C), 60 (2.2%) received seven\u2212\/eight-dose iBCG plus mBCG, and 141 (5.3%) received only \u22645-dose iBCG. Recurrence-free survival (RFS), progression-free survival, and cancer-specific survival were estimated and compared using Kaplan\u2013Meier analysis and the log-rank test, respectively. Propensity score-based one-to-one matching was performed using a multivariable logistic regression model based on covariates to obtain balanced groups. To eliminate possible immortal bias, 6-, 12-, 18-, and 24-month conditional landmark analyses of RFS were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      RFS comparison confirmed that mBCG yielded significant benefit following six-dose iBCG (Group B) in recurrence risk reduction compared to iBCG alone (groups A and C) before (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0016, respectively) and after propensity score matching (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0074, respectively). Propensity score-matched sequential landmark analyses revealed no significant differences between groups B and C at 12, 18, and 24\u2009months, whereas landmark analyses at 6 and 12\u2009months showed a benefit of mBCG following six-dose iBCG compared to non-maintenance six-dose iBCG (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0055 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032, respectively). There were no significant differences in the risks of progression and cancer-specific death in all comparisons of the matched cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although non-maintenance eight-dose iBCG was inferior to six-dose iBCG plus mBCG, the former might be an alternative remedy in the BCG shortage era. To overcome this challenge, further investigation is warranted to confirm the real clinical value of non-maintenance eight-dose iBCG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12885-021-07966-7","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T06:03:13Z","timestamp":1615442593000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Non-maintenance intravesical Bacillus Calmette\u2013Gu\u00e9rin induction therapy with eight doses in patients with high- or highest-risk non-muscle invasive bladder cancer: a retrospective non-randomized comparative study"],"prefix":"10.1186","volume":"21","author":[{"name":"on behalf of the Japanese Urological Oncology Group","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-7356","authenticated-orcid":false,"given":"Makito","family":"Miyake","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Iida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Nishimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuki","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohide","family":"Fujimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryotaro","family":"Tomida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Numakura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Inokuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Morizane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Yoneyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Matsumura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashige","family":"Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Terada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuya","family":"Hirao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motohide","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Matsushita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikiya","family":"Taoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Kojima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kitamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Nishiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"7966_CR1","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1111\/iju.12749","volume":"22","author":"M Miyake","year":"2015","unstructured":"Miyake M, Gotoh D, Shimada K, et al. 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The methods and procedures for this study were approved by the Ethics Committee of the Nara Medical University (reference protocol ID: 2217). Informed consent was obtained from patients or his\/her representatives through posters and\/or website using the opt-out method. Official names of institutional review board of each collaborating institute are listed here: the Medical ethics committee at Osaka University; the ethics committee of Kagawa University Faculty of Medicine; the Ethics Committee on Clinical Research, Kagoshima University; the Medical Ethics Committee for Kitasato University; the Kyushu University Hospital Ethics Committee; the Ethics Committee Graduate School and Faculty of Medicine Kyoto University; the Ethics committee of The Jikei University School of Medicine for Biomedical Research; the Ethics Committee of Shimane University; the Ethics Committee of Chiba University; the Ethics in Human Subject Research at the University of Tsukuba; the Ethics Committee of University of Toyama; the Ethical committee of Harasanshin Hospital; the Committee of Medical Ethics of Hirosaki University Graduate School of Medicine; the Independent Ethics Committee of Hokkaido University Graduate School of Medicine; the Ethical Review Committee of Yamagata University Faculty of Medicine; the Research Ethics Committee of University of Miyazaki; the Medical Ethics Review board of the Kyoto Prefectural University of Medicine; the Ethical committee of National Cancer Center Research Institute; the Ethical committee National Cancer Center Research Institute East; the Shikoku Cancer Center Ethics Committee; the Akita University School of Medicine Ethics Committee; Tottori University Faculty of Medicine Ethics Committee; the Tohoku University Graduate School of Medicine Ethics Committee; the Ethics Committee of Hamamatsu University School of Medicine; the Ethics Committee of Nara Prefecture General Medical Center; the Ethics Committee of Kokuho Chuo Hosiptal; the Ethics Committee of Nara City Hospital; the Ethics Committee of Yamato Koriyama Hospital; the Ethics Committee of Hirao Hospital; the Ethics Committee of Saiseikai Chuwa Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. This manuscript contains no individual person\u2019s data in any form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"266"}}