{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:57:42Z","timestamp":1790618262946,"version":"4.1.0"},"reference-count":20,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Objectives: To determine whether the timing of radical cystectomy (RC), either early versus delayed following BCG therapy, affects perioperative outcomes and health-related quality of life (HRQOL) in patients with very-high-risk non\u2013muscle invasive bladder cancer (NMIBC). While existing data focus on oncological endpoints, the impact of BCG on these outcomes remains unevaluated. Methods: We retrospectively analysed a prospectively maintained database of 126 patients undergoing RC for very-high-risk NMIBC at a tertiary referral centre, stratified into early RC (n = 81) and delayed RC (n = 45, following BCG therapy). Perioperative outcomes, HRQOL assessed by EORTC-QLQ-C30 at baseline and 3, 12, and 24 months postoperative, and overall survival (OS) were compared. Longitudinal HRQOL changes were analysed using linear mixed-effects models adjusted for age and Carcinoma in situ (CIS) status, correcting for multiple comparisons. Results: Groups were well-balanced at baseline regarding age, sex, BMI, and ECOG performance status. No significant between-group differences were observed in overall complication rates, hospital stay length, or any QLQ-C30 domain at any timepoint, including global health status (GHS), in linear mixed-effects models accounting for repeated measures and multiple comparisons. OS did not differ between groups (p = 0.720). Conclusions: Prior BCG therapy does not adversely influence perioperative outcomes or HRQOL following RC for very-high-risk NMIBC. These findings support the initial use of BCG in eligible patients, as a trial of intravesical therapy does not appear to compromise surgical safety or postoperative quality of life when cystectomy is ultimately required.<\/jats:p>","DOI":"10.3390\/jcm15197486","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:50:54Z","timestamp":1790614254000},"page":"7486","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Timing Matter? Perioperative Outcomes and Quality of Life After Early Versus Delayed Radical Cystectomy Following BCG Therapy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-9398","authenticated-orcid":false,"given":"Yannic","family":"Volz","sequence":"first","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Ghali","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Pyrgidis","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3471-4701","authenticated-orcid":false,"given":"Matthias P.","family":"Fabritius","sequence":"additional","affiliation":[{"name":"Department of Radiology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Ebner","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5634-3627","authenticated-orcid":false,"given":"Marie","family":"Semmler","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2072-5521","authenticated-orcid":false,"given":"Marc","family":"Kidess","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Scheuringer","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5304-817X","authenticated-orcid":false,"given":"Julian","family":"Marcon","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1565-1258","authenticated-orcid":false,"given":"Patrick","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-0304","authenticated-orcid":false,"given":"Gerald Bastian","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3291-9460","authenticated-orcid":false,"given":"Christian","family":"Stief","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich","family":"Jokisch","sequence":"additional","affiliation":[{"name":"Department of Urology, LMU University Hospital, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Grabe-Heyne, K., Henne, C., Mariappan, P., Geiges, G., P\u00f6hlmann, J., and Pollock, R.F. 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