Gender-Specific Differences in Recurrence and Progression following Bacillus Calmette-Guérin Instillation for Non-Muscle-Invasive Bladder Cancer

Urologia Internationalis, vol. 109, pp. 412–424

Abstract

INTRODUCTION: To assess gender-specific differences in recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) among patients with intermediate or high-risk non-muscle-invasive bladder cancer (NMIBC) receiving BCG was the primary aim of this systematic review and meta-analysis. METHODS: In July 2023, we performed a literature search using MEDLINE, Embase, and the Cochrane Library. This study was prospectively registered at PROSPERO (CRD 2023443269). The detailed review protocol is accessible via CRD. RESULTS: The systematic literature search identified 6,723 studies, of which 38 fulfilled the inclusion criteria. Random-effect meta-analysis for RFS, based on data from 24 studies, revealed no statistically significant gender-specific difference (HR comparing males to females = 0.9618, 95% CI: 0.8408-1.1003, p = 0.5707). Similarly, for PFS, incorporating data from 14 studies, no statistically significant difference (HR = 0.9540, 95% CI: 0.7709-1.1805, p = 0.6648), for CSS, analysis of data from three studies yielded no statistically significant difference (HR = 0.9228, 95% CI: 0.6196-1.3743, p = 0.6925), and for OS, based on data from two studies, no statistically significant difference was observed (HR = 1.1436, 95% CI: 0.5092-2.5684, p = 0.7452). The risk of bias assessment indicated an overall moderate to high risk of bias. CONCLUSION: The findings indicate no association between gender and oncologic outcomes following BCG.

Authors 8

1. Laila Schneidewind corresponding

   Universitätsmedizin Greifswald · University Hospital of Bern · Universität Greifswald

   Affiliation as printed

   Department of Hematology/Oncology, University Medical Center Greifswald, Greifswald, Germany

   Department of Urology, University Hospital of Bern, Bern, Switzerland

2. Bernhard M. Kiss

   University Hospital of Bern

   Affiliation as printed

   Department of Urology, University Hospital of Bern, Bern, Switzerland

3. Jennifer Kranz Aachen Department of Urology and Pediatric Urology

   Universitätsklinikum Aachen · Martin Luther University Halle-Wittenberg · RWTH Aachen University

   Affiliation as printed

   Department of Urology and Kidney Transplantation, Martin Luther University, Halle, Germany

   Department of Urology and Pediatric Urology, University Medical Center RWTH Aachen, Aachen, Germany

4. Friedemann Zengerling

   University Hospital Ulm

   Affiliation as printed

   Department of Urology and Pediatric Urology, University Hospital Ulm, Ulm, Germany

5. Angelika Borkowetz

   Technische Universität Dresden

   Affiliation as printed

   Department of Urology, Technical University Dresden, Dresden, Germany

6. Sebastián Graf

   Kepler Universitätsklinikum

   Affiliation as printed

   Department of Urology and Andrology, Kepler University Hospital Linz, Linz, Austria

7. Annabel Graser

   Ludwig-Maximilians-Universität München

   Affiliation as printed

   Department of Urology, Ludwig Maximilian University, Munich, Germany

8. Annemarie Uhlig

   Universitätsmedizin Göttingen · University of Göttingen

   Affiliation as printed

   Department of Urology, University Medical Center Göttingen, Göttingen, Germany