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

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