Fig. 2.
Kaplan-Meier analysis to evaluate RFS in patients within each subgroup. Comparisons were performed by log-rank test. (A) RFS in all patients was 96.7% at 1 yr and 81.7% at 5 yr after the last BCG instillation. (B) Before TURBT, 5-yr RFS rate in the urine cytology positive group (classes IV and V, 59.7%) was significantly lower than that in the urine cytology negative group (classes II and III, 90.1%; p < 0.001). (C) Significant difference in 5-yr RFS rate between patients with initial BC (91.2%) and patients with recurrent BC (72.1%; p = 0.017). (D) The Tokyo 172 strain group had a significantly lower 5-yr RFS rate (71.3%) than the Connaught strain group (89.1%; p = 0.009). (E) RFS rate in the maintenance group was significantly higher than that in the only induction group (p = 0.043). (F) For the CUETO recurrence risk group, there were significant differences in 5-yr RFS rate between recurrence scores 0–4 (100.0%), 5–6 (92.0%), 7–9 (70.2%), and 10–16 (70.0%; p = 0.009). (G) Compared with patients with no positive MTC-PCR results, RFS rate in the group with a positive MTC-PCR result at least once was significantly higher (p < 0.001). Compared with patients with a negative MTC-PCR result, RFS rate in the group with a positive MTC-PCR result at (H) 1, (I) 2, (J) 3, and (K) 4 yr after the last BCG instillation was significantly higher (p < 0.001). (L) ROC curve results showed the area under the curve (AUC) values of five factors that were significantly different in univariate Cox analysis. The AUC values of age, urine cytology, recurrence history, BCG strain, CUETO recurrence risk, and MTC-PCR were 0.717 (95% CI: 0.600–0.835), 0.680 (95% CI: 0.560–0.800), 0.629 (95% CI: 0.515–0.742), 0.613 (95% CI: 0.491–0.735), 0.697 (95% CI: 0.598–0.795), and 0.868 (95% CI: 0.767–0.970), respectively. The AUC of MTC-PCR was significantly higher than that of age (p = 0.044), urine cytology (p = 0.017), recurrence history (p = 0.007), BCG strain (p < 0.0001), or CUETO recurrence risk (p = 0.023). BCG = bacillus Calmette-Guérin; CI = confidence interval; CUETO = Club Urologico Espanol de Tratamiento Oncologico; FPF = false positive fraction; MTC-PCR = M. tuberculosis complex polymerase chain reaction; ROC = receiver-operating characteristic; RFS = recurrence-free survival; TPF = true positive fraction; TURBT = transurethral resection of bladder tumor.
