{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:35:31Z","timestamp":1790807731996,"version":"4.1.0"},"reference-count":61,"publisher":"Korean Cancer Association","issue":"2","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100003645","name":"National Cancer Center","doi-asserted-by":"publisher","award":["NCC-2211590"],"award-info":[{"award-number":["NCC-2211590"]}],"id":[{"id":"10.13039\/501100003645","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-crt.org"],"crossmark-restriction":true},"short-container-title":["Cancer Res Treat"],"published-print":{"date-parts":[[2026,4,15]]},"abstract":"<jats:p>PurposeThis study aimed to report the real-world outcomes of intravesical gemcitabine for bacillus Calmette\u2013Gu\u00e9rin (BCG)\u2013unresponsive, high-risk, non\u2013muscle-invasive bladder cancer (HR-NMIBC) in Korean patients who were unable or unwilling to undergo radical cystectomy (RC).Materials and MethodsThis retrospective study included 131 patients (median age, 69 years; 88.5% men) treated with intravesical gemcitabine for BCG-unresponsive HR-NMIBC at nine centers between May 2019 and April 2022. The primary endpoint was 1-year recurrence-free survival (RFS). The secondary endpoints included factors influencing RFS, progression-free survival (PFS), cystectomy- free survival, cancer-specific survival (CSS), overall survival (OS), and safety. Survival analysis was performed using the Kaplan-Meier method, and risk factors for recurrence were assessed using Cox regression models.ResultsPatients were followed up for a median duration of 25 months, with carcinoma in situ (CIS) in 41.9% of the patients. The 1-year and 2-year RFS rates were 68% and 42%, while the 1-year and 2-year PFS rates were 87% and 77%, respectively. No significant factors influencing RFS were identified. Seventeen patients underwent RC during a median follow-up of 16 months, with the condition in three patients progressing to muscle-invasive disease on final pathological analysis. The 2-year CSS and OS rates were 98% and 97%, respectively. Intravesical gemcitabine was well-tolerated, with only seven patients (5.3%) unable to complete the full induction course.ConclusionOur research highlights the potential of intravesical gemcitabine as a viable bladder-sparing treatment option for BCG-unresponsive HR-NMIBC, providing real-world evidence on its safety, efficacy, and tolerability.<\/jats:p>","DOI":"10.4143\/crt.2025.100","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T03:56:56Z","timestamp":1747022216000},"page":"591-602","update-policy":"https:\/\/doi.org\/10.4143\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-World Efficacy of Intravesical Gemcitabine for BCG-Unresponsive Non\u2013muscle-Invasive Bladder Cancer"],"prefix":"10.4143","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0303-4658","authenticated-orcid":true,"given":"Hye 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