Association of patients' sex with treatment outcomes after intravesical bacillus Calmette-Guerin immunotherapy for T1G3/HG bladder cancer
Por:
D'Andrea, D, Soria, F, Grotenhuis, AJ, Cha, EK, Malats, N, Di Stasi, S, Joniau, S, Cai, T, van Rhijn, BWG, Irani, J, Karnes, J, Varkarakis, J, Baniel, J, Palou, J, Babjuk, M, Spahn, M, Ardelt, P, Colombo, R, Serretta, V, Dalbagni, G, Gontero, P, Bartoletti, R, Larre, S, Malmstrom, PU, Sylvester, R, Shariat, SF
Publicada:
1 sep 2021
Ahead of Print:
1 mar 2021
Resumen:
Purpose To investigate the association of patients' sex with recurrence and disease progression in patients treated with intravesical bacillus Calmette-Guerin (BCG) for T1G3/HG urinary bladder cancer (UBC). Materials and methods We analyzed the data of 2635 patients treated with adjuvant intravesical BCG for T1 UBC between 1984 and 2019. We accounted for missing data using multiple imputations and adjusted for covariate imbalance between males and females using inverse probability weighting (IPW). Crude and IPW-adjusted Cox regression analyses were used to estimate the hazard ratios (HR) with their 95% confidence intervals (CI) for the association of patients' sex with HG-recurrence and disease progression. Results A total of 2170 (82%) males and 465 (18%) females were available for analysis. Overall, 1090 (50%) males and 244 (52%) females experienced recurrence, and 391 (18%) males and 104 (22%) females experienced disease progression. On IPW-adjusted Cox regression analyses, female sex was associated with disease progression (HR 1.25, 95%CI 1.01-1.56, p = 0.04) but not with recurrence (HR 1.06, 95%CI 0.92-1.22, p = 0.41). A total of 1056 patients were treated with adequate BCG. In these patients, on IPW-adjusted Cox regression analyses, patients' sex was not associated with recurrence (HR 0.99, 95%CI 0.80-1.24, p = 0.96), HG-recurrence (HR 1.00, 95%CI 0.78-1.29, p = 0.99) or disease progression (HR 1.12, 95%CI 0.78-1.60, p = 0.55). Conclusion Our analysis generates the hypothesis of a differential response to BCG between males and females if not adequately treated. Further studies should focus on sex-based differences in innate and adaptive immune system and their association with BCG response.
Filiaciones:
D'Andrea, D:
Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
Soria, F:
Univ Studies Turin, AOU Citta Salute & Sci Torino, Div Urol, Turin, Italy
Grotenhuis, AJ:
Radboud Univ Nijmegen, Med Ctr, Dept Urol, Nijmegen, Netherlands
Cha, EK:
Cornell Univ, Weill Med Coll, Dept Urol, New York, NY USA
Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA
Malats, N:
Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain
Di Stasi, S:
Univ Rome, Policlin Tor Vergata, Dept Urol, Rome, Italy
Joniau, S:
Univ Hosp Leuven, Dept Urol, Oncol & Reconstruct Urol, Leuven, Belgium
Cai, T:
Santa Chiara Hosp, Dept Urol, Trento, Italy
van Rhijn, BWG:
Antoni von Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Surg Oncol Urol, Amsterdam, Netherlands
Irani, J:
Univ Poitiers, Ctr Univ La Miletrie, Dept Urol, Poitiers, France
Karnes, J:
Mayo Clin, Dept Urol, Rochester, MN USA
Baniel, J:
Rabin Med Ctr, Dept Urol, Tel Aviv, Israel
Palou, J:
Univ Athens, Sismanoglio Hosp, Dept Urol, Athens, Greece
Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
Babjuk, M:
Univ Praha, Motol Hosp, Dept Urol, Prague, Czech Republic
Spahn, M:
Univ Hosp Wuerzburg, Dept Urol, Wuertzburg, Germany
Ardelt, P:
Univ Klin Freiburg, Dept Urol, Freiburg, Germany
Colombo, R:
Univ Vita Salute, Dept Urol, Osped S Raffaele, Milan, Italy
Serretta, V:
Univ Palermo, Dept Surg Oncol & Stomatol Sci, Palermo, Italy
Dalbagni, G:
Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA
Gontero, P:
Univ Studies Turin, AOU Citta Salute & Sci Torino, Div Urol, Turin, Italy
Bartoletti, R:
Univ Pisa, Dept Translat Res & New Technol, Pisa, Italy
Larre, S:
CHU Reims, Dept Urol, Reims, France
Malmstrom, PU:
Uppsala Univ, Acad Hosp, Dept Urol, Uppsala, Sweden
Sylvester, R:
European Assoc Urol Nonmuscle Invas Bladder Canc, Brussels, Belgium
Shariat, SF:
Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
Cornell Univ, Weill Med Coll, Dept Urol, New York, NY USA
Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA
Charles Univ Prague, Fac Med 2, Dept Urol, Prague, Czech Republic
IM Sechenov First Moscow State Med Univ, Inst Urol & Reprod Hlth, Moscow, Russia
Univ Jordan, Dept Urol, Amman, Jordan
European Assoc Urol Res Fdn, Arnhem, Netherlands
Green Published, hybrid
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