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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Antineoplastic Agents, BCG Vaccine, Carcinoma in Situ, Chi-Square Distribution, Disease-Free Survival, Gene Frequency, Genetic Predisposition to Disease, Humans, Interleukin-4, Kaplan-Meier Estimate, Neoplasms, Multiple Primary, Odds Ratio, Phenotype, Polymorphism, Genetic, Portugal, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Tumor Necrosis Factor-alpha, Urinary Bladder Neoplasms.
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Are iL-4 and TNF-α polymorphisms associated with risk of multiple superficial tumors or carcinoma in situ development? Context: This study evaluates the influence of clinicopathological characteristics, bacillus Calmette-Guérin (BCG) therapeutic schedule [maintenance (mBCG) or induction (iBCG)], and TNF-α and IL-4 polymorphisms on the outcome of non-muscle-invasive bladder cancer patients treated with BCG. DNA was extracted from 125 bladder cancer patients treated with BCG; TNF-308G/A and IL4-590C/T polymorphisms were genotyped. The TNF-308A allele carriers had an increased risk of developing multiple tumors (OR: 2.80, p = 0.031). However, IL4-590 T carriers also had an increased risk of developing multiple and carcinoma in situ tumors (OR: 2.52, p = 0.033). For these polymorphisms, no association was found with BCG treatment outcome. When treated with iBCG, patients with multiple tumors had shorter recurrence-free survival (RFS) compared with those with a single tumor (p = 0.004); nevertheless, patients with multifocal tumors have improved RFS when treated with mBCG.
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Overall, the results suggest that multiple tumors and/or carcinoma in situ development are associated with the IL4-590C/T and TNF-308G/A polymorphisms, and emphasize the effectiveness of the mBCG schedule. Final Decision: yes