The Influence of Dietary Isothiocyanates on the Effectiveness of Mitomycin C and Bacillus Calmette-Guérin in Treating Nonmuscle-Invasive Bladder Cancer.
J Urol
; 212(3): 420-430, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-38848543
ABSTRACT
PURPOSE:
Nonmuscle-invasive bladder cancer (NMIBC) has high recurrence rates and is often treated with mitomycin C (MMC) and bacillus Calmette-Guérin (BCG). Their efficacy relies on phase 2 enzyme metabolism and immune response activation, respectively. Dietary isothiocyanates, phytochemicals in cruciferous vegetables, are phase 2 enzyme inducers and immunomodulators, and may impact treatment outcomes. We investigated the modifying effects of cruciferous vegetable and isothiocyanate intake on recurrence risk following MMC or BCG treatment. MATERIALS ANDMETHODS:
Self-reported cruciferous vegetable intake, estimated isothiocyanate intake, and urinary isothiocyanate metabolites were collected from 1158 patients with incident NMIBC in the prospective Be-Well Study. Hazard ratios (HRs) and 95% CIs were calculated from Cox proportional hazards regression models for risk of first recurrences, and random effects Cox shared frailty models for multiple recurrences.RESULTS:
Over median follow-up of 23 months, 343 (30%) recurrences occurred. Receipt of MMC and BCG was associated with decreased risks of first recurrence (MMC HR = 0.58; 95% CI 0.46-0.73; BCG HR = 0.66; 95% CI 0.49-0.88) and multiple recurrences (MMC HR = 0.55; 95% CI 0.44-0.68; BCG HR = 0.72; 95% CI 0.55-0.95). Patients receiving BCG and having high intake (>2.4 servings/mo), but not low intake, of raw cruciferous vegetables had reduced risk of recurrence (HR 0.56; 95% CI 0.36-0.86; P for interaction = .02) and multiple recurrences (HR 0.51; 95% CI 0.34-0.77; P for interaction < .001). The inverse association between MMC receipt and recurrence risk was not modified.CONCLUSIONS:
For NMIBC patients who receive induction BCG, increasing consumption of raw cruciferous vegetables could be a promising strategy to attenuate recurrence risk.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Vejiga Urinaria
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Vacuna BCG
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Mitomicina
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Isotiocianatos
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Recurrencia Local de Neoplasia
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2024
Tipo del documento:
Article