Efficacy of bacillus Calmette-Guérin in the treatment of superficial bladder cancer: the impact of previous intravesical treatment.

Abstract

OBJECTIVE:

To clinically evaluate the role of intravesical bacillus Calmette-Guérin (BCG) in the management of superficial bladder cancer, focusing on dose, age, high grade/stage, and pretreatment episodes with other therapies in long-term follow-up patients.

METHODS:

A total of 213 patients with superficial (Ta-T1) transitional cell carcinoma of the bladder received 6-8 weekly instillations of 40, 60 or 80 mg of Tokyo strain BCG. Further 6-8 monthly applications were given in some cases.

RESULTS:

Recurrence-free and progression-free survival rates were compared with reference to dose, age, previous treatment, grade, stage, and high risk categories. Overall recurrence-free rates for 3, 5, and 10 years were 70.8%, 67.1%, and 57.6%, with progression-free survival rates of 94.5%, 93.6%, 90.6%, respectively. In univariate analyses, younger cases demonstrated higher recurrence-free survival rates, but without statistical significance (P = 0.1229). Recurrence-free rates were significantly higher for cases without previous intravesical treatment (P = 0.0010). There was no significant BCG dose-dependence. High grade and high stage patients were confirmed as having higher recurrence and progression rates.

CONCLUSIONS:

Intravesical instillation of BCG is the most effective in the long term when chosen as the initial prophylactic therapy for the prevention of recurrence in superficial bladder cancer.

• Authors: Takehiko Okamura, Hidetoshi Akita, Makoto Imura, Tomoyoshi Kaneko, Kentaro Mizuno, Keiichi Tozawa, Kenjiro Kohri
• Journal: International journal of urology : official journal of the Japanese Urological Association (Int J Urol) Vol. 15 Issue 11 Pg. 976-80 (Oct 2008) ISSN: 1442-2042 [Electronic] Australia
• PMID: 18721199 (Publication Type: Journal Article)

Chemical References

• Adjuvants, Immunologic
• BCG Vaccine

Topics

• Adjuvants, Immunologic (therapeutic use)
• Adult
• Aged
• Aged, 80 and over
• BCG Vaccine (therapeutic use)
• Carcinoma, Transitional Cell (drug therapy, pathology)
• Disease-Free Survival
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (epidemiology, prevention & control)
• Retreatment
• Retrospective Studies
• Urinary Bladder Neoplasms (drug therapy, pathology)