Effect of intravesical bacillus calmette‐guerin (BCG) on carcinoma in situ of the bladder Academic Article Article uri icon

Overview

MeSH Major

  • Cystadenocarcinoma
  • Prostatic Neoplasms

abstract

  • Development of invasive bladder cancer is a definite risk in patients with flat carcinoma in situ (CIS) associated with multifocal concurrent superficial papillary tumors. In a prior prospective randomized trial, the authors showed that intravesical BCG reduces local tumor recurrences and prolongs the disease free interval in patients with recurrent, papillary bladder tumors treated by transurethral resection (TUR) and/or fulguration. In this study, BCG was administered intravesically, 120 mg in 50 ml saline and percutaneously, 5 × 107 viable organisms, weekly for 6 weeks. The current study was conducted to determine the impact of this regimen in patients with flat in situ carcinoma. Of the first 69 patients entered, 41 (59%) had multiple (2) lesions of flat CIS associated with papillary tumors: 17/34 (50%) in the TUR + BCG group and 24/35 (69%) in the TUR alone group. Complete regression of CIS documented by negative bladder biopsy and negative urine cytology results was seen in 11/17 (65%) of the BCG treated patients for a median duration of 18 months (range, 12–30 months) and in 2/24 (8%) patients in the TUR alone group for a median duration of 3 months (P < 0.01). In situ carcinoma failed to respond to intravesical BCG in seven patients, three of whom required cystectomy for local progression of disease. In two of these three patients, cystectomy was performed for CIS involving the prostatic ducts and no tumor was found in the bladder specimen. This suggested that the response of in situ cancer required that the epithelium be adequately exposed to BCG, and that intravesical BCG + TUR may potentially reverse the insidious natural history of carcinoma in situ compared with a control group treated with endoscopic destruction alone. Copyright © 1983 American Cancer Society

publication date

  • January 1983

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1002/1097-0142(19830401)51:7<1323::AID-CNCR2820510724>3.0.CO;2-2

PubMed ID

  • 6337700

Additional Document Info

start page

  • 1323

end page

  • 6

volume

  • 51

number

  • 7