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Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer
PURPOSE: To investigate the association of patients’ sex with recurrence and disease progression in patients treated with intravesical bacillus Calmette–Guérin (BCG) for T1G3/HG urinary bladder cancer (UBC). MATERIALS AND METHODS: We analyzed the data of 2635 patients treated with adjuvant intravesi...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510956/ https://www.ncbi.nlm.nih.gov/pubmed/33713162 http://dx.doi.org/10.1007/s00345-021-03653-1 |
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author | D’Andrea, David Soria, Francesco Grotenhuis, Anne J. Cha, Eugene K. Malats, Nuria Di Stasi, Savino Joniau, Steven Cai, Tommaso van Rhijn, Bas W. G. Irani, Jaques Karnes, Jeffrey Varkarakis, John Baniel, Jack Palou, Joan Babjuk, Marek Spahn, Martin Ardelt, Peter Colombo, Renzo Serretta, Vincenzo Dalbagni, Guido Gontero, Paolo Bartoletti, Riccardo Larré, Stephane Malmstrom, Per-Uno Sylvester, Richard Shariat, Shahrokh F. |
author_facet | D’Andrea, David Soria, Francesco Grotenhuis, Anne J. Cha, Eugene K. Malats, Nuria Di Stasi, Savino Joniau, Steven Cai, Tommaso van Rhijn, Bas W. G. Irani, Jaques Karnes, Jeffrey Varkarakis, John Baniel, Jack Palou, Joan Babjuk, Marek Spahn, Martin Ardelt, Peter Colombo, Renzo Serretta, Vincenzo Dalbagni, Guido Gontero, Paolo Bartoletti, Riccardo Larré, Stephane Malmstrom, Per-Uno Sylvester, Richard Shariat, Shahrokh F. |
author_sort | D’Andrea, David |
collection | PubMed |
description | PURPOSE: To investigate the association of patients’ sex with recurrence and disease progression in patients treated with intravesical bacillus Calmette–Guérin (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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00345-021-03653-1. |
format | Online Article Text |
id | pubmed-8510956 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-85109562021-10-27 Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer D’Andrea, David Soria, Francesco Grotenhuis, Anne J. Cha, Eugene K. Malats, Nuria Di Stasi, Savino Joniau, Steven Cai, Tommaso van Rhijn, Bas W. G. Irani, Jaques Karnes, Jeffrey Varkarakis, John Baniel, Jack Palou, Joan Babjuk, Marek Spahn, Martin Ardelt, Peter Colombo, Renzo Serretta, Vincenzo Dalbagni, Guido Gontero, Paolo Bartoletti, Riccardo Larré, Stephane Malmstrom, Per-Uno Sylvester, Richard Shariat, Shahrokh F. World J Urol Original Article PURPOSE: To investigate the association of patients’ sex with recurrence and disease progression in patients treated with intravesical bacillus Calmette–Guérin (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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00345-021-03653-1. Springer Berlin Heidelberg 2021-03-13 2021 /pmc/articles/PMC8510956/ /pubmed/33713162 http://dx.doi.org/10.1007/s00345-021-03653-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article D’Andrea, David Soria, Francesco Grotenhuis, Anne J. Cha, Eugene K. Malats, Nuria Di Stasi, Savino Joniau, Steven Cai, Tommaso van Rhijn, Bas W. G. Irani, Jaques Karnes, Jeffrey Varkarakis, John Baniel, Jack Palou, Joan Babjuk, Marek Spahn, Martin Ardelt, Peter Colombo, Renzo Serretta, Vincenzo Dalbagni, Guido Gontero, Paolo Bartoletti, Riccardo Larré, Stephane Malmstrom, Per-Uno Sylvester, Richard Shariat, Shahrokh F. Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer |
title | Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer |
title_full | Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer |
title_fullStr | Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer |
title_full_unstemmed | Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer |
title_short | Association of patients’ sex with treatment outcomes after intravesical bacillus Calmette–Guérin immunotherapy for T1G3/HG bladder cancer |
title_sort | association of patients’ sex with treatment outcomes after intravesical bacillus calmette–guérin immunotherapy for t1g3/hg bladder cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510956/ https://www.ncbi.nlm.nih.gov/pubmed/33713162 http://dx.doi.org/10.1007/s00345-021-03653-1 |
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