{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T11:07:10Z","timestamp":1779448030230,"version":"3.53.1"},"reference-count":28,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Although intravesical Bacillus Calmette\u2013Gu\u00e9rin (BCG) is an established adjuvant therapy for non-muscle-invasive bladder cancer (NMIBC), chronic global shortages and adverse events (AEs) can occur. Thus, intravesical gemcitabine has been used as an alternative. We compared the long-term oncological outcomes and safety profiles of BCG and gemcitabine in treatment-na\u00efve patients with intermediate- and high-risk NMIBC. Methods: Patients with intermediate- and high-risk NMIBC (n = 477) received adjuvant intravesical induction and maintenance therapy with intravesical BCG (n = 361) or gemcitabine (n = 116) and their data were collected retrospectively. Results: Compared with the gemcitabine group, the BCG group had significantly higher proportions of patients with T1 stage, high-grade tumors, high-risk tumors, and longer median follow-up duration. Over a median 36-month observation period, the BCG group exhibited significantly better recurrence-free survival (RFS) and high-grade RFS (HG-RFS) than the gemcitabine group. In the propensity score\u2013matched high-risk population, BCG also outperformed gemcitabine in RFS and HG-RFS. BCG therapy was identified as a potent protective predictor, reducing the risk of recurrence and high-grade recurrence by 65% and 66%, respectively, in the total cohort, and by 69% and 71%, respectively, in the propensity score-matched high-risk subgroup. No significant differences were observed in the frequency of grade \u2265 3 AEs between BCG and gemcitabine. Conclusions: Intravesical BCG is strongly associated with superior oncological outcomes over gemcitabine in intermediate- and high-risk NMIBC. The results of this study offer pivotal practice-based insights to guide clinical strategies for managing NMIBC.<\/jats:p>","DOI":"10.3390\/jcm15103890","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:40:31Z","timestamp":1779115231000},"page":"3890","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Long-Term Oncological Outcomes of Intravesical Bacillus Calmette\u2013Gu\u00e9rin Versus Gemcitabine in Treatment-Na\u00efve Non-Muscle-Invasive Bladder Cancer with Intermediate and High Risk: A Multicenter Retrospective Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7162-6527","authenticated-orcid":false,"given":"Kyung Hwan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-5895","authenticated-orcid":false,"given":"Byeong Jin","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soodong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Urology, Dong-A University College of Medicine, Busan 49201, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3460-9386","authenticated-orcid":false,"given":"Ja Yoon","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Urology, Dongnam Institute of Radiological and Medical Sciences, Busan 46033, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8240-7765","authenticated-orcid":false,"given":"Hong Koo","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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