title: Tumor multiplicity is an independent prognostic factor of non-muscle-invasive bladder cancer treated with Bacillus Calmette-Guerin immunotherapy.
abstract: BACKGROUND
  Bacillus Calmette-Guerin (BCG) immunotherapy is regarded as the current treatment of choice for non muscle invasive bladder cancer (NMIBC), though its efficacy is limited by high recurrence and progression rate. Identification of factor prognosticators that might be helpful in discriminating between responders and nonresponders to BCG treatment is therefore of major clinical importance. The aim of this study is to evaluate the prognostic factors of recurrence after intravesical adjuvant BCG immunotherapy in patients with NMIBC.
  
  
  METHODS
  we retrospectively reviewed the clinical and pathologic data of primary NMIBC from 112 patients who were treated with transurethral resection followed by BCG-immunotherapy. Time follow-up was 30 months. The prognostic significance of tumor stage, grade, multiplicity, age, sex and smoking in determining the risk for recurrence after BCG therapy was studied with both univariate and multivariate methods of analysis.
  
  
  RESULTS
  According to univariate analysis of the prognostic significance for tumor stage, grade, loci number, sex, age and smoking, the pT1 stage and multiplicity seem to be associated in a statistically significant manner with higher risk for recurrence (P = 0.009, P = 0.011, respectively). In the other hand, multivariate analysis showed that only multiplicity was an independent significant prognosticator.
  
  
  CONCLUSIONS
  Significant independent predictor for recurrence was multiplicity which offers important clinical information and may be a useful tool in the selection of suitable candidates for BCG-immunotherapy.
authors.affiliation: Laboratory of Human and Experimental Pathology, Pasteur Institute of Tunis, Tunisia. Faouziaagili@yahoo.fr
authors.forename: Faouzia
authors.initials: F
authors.lastname: Ajili
authors.forename: Mohamed
authors.initials: M
authors.lastname: Manai
authors.forename: Amine
authors.initials: A
authors.lastname: Darouiche
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chebil
authors.forename: Samir
authors.initials: S
authors.lastname: Boubaker
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001500:BCG Vaccine / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018579:Patient Selection; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D001500:BCG Vaccine