PMID- 29480348 OWN - NLM STAT- MEDLINE DCOM- 20180828 LR - 20181113 IS - 1559-131X (Electronic) IS - 1357-0560 (Linking) VI - 35 IP - 4 DP - 2018 Feb 26 TI - Impact of bacillus Calmette-Guerin therapy of upper urinary tract carcinoma in situ: comparison of oncological outcomes with radical nephroureterectomy. PG - 41 LID - 10.1007/s12032-018-1102-y [doi] AB - The clinical benefits of bacillus Calmette-Guerin (BCG) therapy for the management of upper urinary tract carcinoma in situ (CIS) remain unclear. We aimed to compare the efficacy and safety of BCG therapy for upper urinary tract CIS with those of radical nephroureterectomy (RNU). Of 490 patients with upper urinary tract carcinoma, we retrospectively reviewed the post-treatment course of 58 patients with upper urinary tract CIS who underwent either RNU (RNU group) or BCG therapy (BCG group). Efficacy and safety were compared between the RNU and BCG groups. Inverse probability treatment-weighted (IPTW)-adjusted multivariate Cox regression analysis was performed to identify the influence of BCG therapy on prognosis. The RNU and BCG groups included 20 and 38 patients, respectively. No significant difference was found in patients' background, including age, sex, and performance status, between the groups. The reason underlying the selection of BCG therapy was bilateral CIS of the upper urinary tract (50%), solitary kidney (26%), unwillingness to undergo RNU (13%), and ineligibility for surgery (11%). The cytology became negative in 30 (79%) out of 38 patients after a 6-week course of BCG therapy, and 17 (57%) out of 30 patients remained negative. BCG-related adverse events (AEs) were observed in 92% of patients. The most common AE was cystitis (76%), followed by fever (50%). No significant differences were found in the progression-free, cancer-specific, and overall survivals between the RNU and BCG groups. IPTW-adjusted multivariate analysis revealed that BCG therapy did not worsen the prognosis of these patients. The limitations of our study were its retrospective design and small sample size. In conclusion, BCG therapy for upper urinary tract CIS might be a useful alternative for patient ineligible for RNU under careful observation for AEs. FAU - Horiguchi, Hirotaka AU - Horiguchi H AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Yoneyama, Takahiro AU - Yoneyama T AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Hatakeyama, Shingo AU - Hatakeyama S AUID- ORCID: 0000-0002-0026-4079 AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. shingoh@hirosaki-u.ac.jp. FAU - Tokui, Noriko AU - Tokui N AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Sato, Tendo AU - Sato T AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Fujita, Naoki AU - Fujita N AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Yamamoto, Hayato AU - Yamamoto H AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Tobisawa, Yuki AU - Tobisawa Y AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Yoneyama, Tohru AU - Yoneyama T AD - Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. FAU - Hashimoto, Yasuhiro AU - Hashimoto Y AD - Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. FAU - Koie, Takuya AU - Koie T AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. FAU - Yoshikawa, Kazuaki AU - Yoshikawa K AD - Department of Urology, Mutsu General Hospital, Mutsu, Japan. FAU - Narita, Satoshi AU - Narita S AD - Department of Urology, Odate General Hospital, Odate, Japan. FAU - Kawaguchi, Toshiaki AU - Kawaguchi T AD - Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan. FAU - Ohyama, Chikara AU - Ohyama C AD - Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. AD - Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. LA - eng GR - 15H02563/Japan Society for the Promotion of Science/ GR - 15K15579/Japan Society for the Promotion of Science/ GR - 17K11118/Japan Society for the Promotion of Science/ GR - 17K11119/Japan Society for the Promotion of Science/ GR - 17K16768/Japan Society for the Promotion of Science/ GR - 17K16770/Japan Society for the Promotion of Science/ GR - 17K16771/Japan Society for the Promotion of Science/ PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20180226 PL - United States TA - Med Oncol JT - Medical oncology (Northwood, London, England) JID - 9435512 RN - 0 (BCG Vaccine) SB - IM MH - Adult MH - Aged MH - BCG Vaccine/*therapeutic use MH - Carcinoma in Situ/*drug therapy/*surgery MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Nephroureterectomy/*methods MH - Prognosis MH - Proportional Hazards Models MH - Retrospective Studies MH - Treatment Outcome MH - Urologic Neoplasms/*drug therapy/*surgery OTO - NOTNLM OT - Bacillus Calmette-Guerin OT - Carcinoma in situ OT - Nephroureterectomy OT - Oncological outcome OT - Upper tract urothelial carcinoma EDAT- 2018/02/27 06:00 MHDA- 2018/08/29 06:00 CRDT- 2018/02/27 06:00 PHST- 2018/01/27 00:00 [received] PHST- 2018/02/23 00:00 [accepted] PHST- 2018/02/27 06:00 [entrez] PHST- 2018/02/27 06:00 [pubmed] PHST- 2018/08/29 06:00 [medline] AID - 10.1007/s12032-018-1102-y [pii] AID - 10.1007/s12032-018-1102-y [doi] PST - epublish SO - Med Oncol. 2018 Feb 26;35(4):41. doi: 10.1007/s12032-018-1102-y.