Research Article

Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study

Volume: 17 Number: July, August, September 2026 September 30, 2026

Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study

Abstract

Purpose:To evaluate clinicopathological factors associated with recurrence and progression in patients with intermediateand high-risk non-muscle-invasive bladder cancer treated with intravesical Bacillus Calmette–Guérin. Methods: This retrospective single-center cohort study included 462 patients with intermediate- or high-risk NMIBC who underwent transurethral resection of bladder tumor followed by intravesical BCG therapy between January 2010 and December 2019. Demographic, clinical, and pathological variables were analyzed. Recurrence-free survival and progression-free survival were estimated using the Kaplan–Meier method. Factors associated with recurrence and progression were evaluated using Cox proportional hazards regression analyses. Results: During the five-year follow-up, recurrence occurred in 128 patients (27.7%) and progression in 57 (12.3%). The 12-, 36-, and 60-month recurrence-free survival rates were 89.6%, 76.4%, and 71.6%, respectively, while the corresponding progression-free survival rates were 96.8%, 90.5%, and 87.6%. In multivariable Cox regression analysis, a history of recurrent tumors (HR 1.48, 95% CI 1.01–2.17; P=.044), tumor size ≥3 cm (HR 1.85, 95% CI 1.25–2.74; P=.002), tumor multifocality (HR 2.12, 95% CI 1.42–3.17; P<.001), and T1 stage (HR 1.58, 95% CI 1.07–2.33; P=.021) were independently associated with recurrence. T1 stage (HR 2.24, 95% CI 1.16–4.33; P=.016) and positive or suspicious urine cytology (HR 1.82, 95% CI 1.02–3.25; P=.043) were independently associated with progression. Conclusion: Recurrence and progression following intravesical BCG therapy were associated with distinct clinicopathological factors. A history of recurrent tumors, tumor size ≥3 cm, multifocality, and T1 stage were independently associated with recurrence, whereas T1 stage and positive or suspicious urine cytology were independently associated with progression. These findings may help refine risk assessment during follow-up after BCG therapy.

Keywords

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Project Number

Not applicable

Ethical Statement

The study protocol was approved by the Health Sciences Ethics Committee of Manisa Celal Bayar University Faculty of Medicine (Approval No. 20.478.486/3011; March 28, 2025). The study was conducted in accordance with the principles of the Declaration of Helsinki. The requirement for informed consent was waived due to the retrospective study design and the use of anonymized clinical data.

Thanks

None.

References

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Details

Primary Language

English

Subjects

Urology

Journal Section

Research Article

Publication Date

September 30, 2026

Submission Date

July 17, 2026

Acceptance Date

September 20, 2026

Published in Issue

Year 2026 Volume: 17 Number: July, August, September 2026

APA
Albaz, A. C., Bilmiş, M., & Muezzinoglu, T. (2026). Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 17(July, August, September 2026). https://doi.org/10.31067/acusaglik.1997738
AMA
1.Albaz AC, Bilmiş M, Muezzinoglu T. Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study. Acibadem Univ Saglik Bilim Derg. 2026;17(July, August, September 2026). doi:10.31067/acusaglik.1997738
Chicago
Albaz, Ali Can, Muhammet Bilmiş, and Talha Muezzinoglu. 2026. “Factors Associated With Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 (July, August, September 2026). https://doi.org/10.31067/acusaglik.1997738.
EndNote
Albaz AC, Bilmiş M, Muezzinoglu T (September 1, 2026) Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 July, August, September 2026
IEEE
[1]A. C. Albaz, M. Bilmiş, and T. Muezzinoglu, “Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study”, Acibadem Univ Saglik Bilim Derg, vol. 17, no. July, August, September 2026, Sept. 2026, doi: 10.31067/acusaglik.1997738.
ISNAD
Albaz, Ali Can - Bilmiş, Muhammet - Muezzinoglu, Talha. “Factors Associated With Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17/July, August, September 2026 (September 1, 2026). https://doi.org/10.31067/acusaglik.1997738.
JAMA
1.Albaz AC, Bilmiş M, Muezzinoglu T. Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study. Acibadem Univ Saglik Bilim Derg. 2026;17. doi:10.31067/acusaglik.1997738.
MLA
Albaz, Ali Can, et al. “Factors Associated With Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol. 17, no. July, August, September 2026, Sept. 2026, doi:10.31067/acusaglik.1997738.
Vancouver
1.Ali Can Albaz, Muhammet Bilmiş, Talha Muezzinoglu. Factors Associated with Recurrence and Progression Following Intravesical Bacillus Calmette–Guérin Therapy in Intermediate- and High-Risk Non-MuscleInvasive Bladder Cancer: A Five-Year RealWorld Cohort Study. Acibadem Univ Saglik Bilim Derg. 2026 Sep. 1;17(July, August, September 2026). doi:10.31067/acusaglik.1997738