Purpose:
@EN Bacillus Calmette-Guerin (BCG0 is the most effective intravesical agent for patients with superficial blader cancer, but the long-term efficacy of BCG has not been established. We report our long-term experience of intravesical BCGS therapy
in
the
recurrence and progression for superficial bladder cancer.
@ES Patients and methods:
@EN Between 1985 and 1993, high risk patients with superficial bladder cancer were received complete TURB plus intravesical BCG (n=770. 120mg Tice-Chicago strain BCG was administered weekly for 6 weeks and then monthly for 3 months. Patients were
considered treatment failure if either urinary cytology or biopsy results were positive for tumor on every to 6 months followup examination. All patients reported have had a minimun 2-year followup, with mean of 63 months.
@ES Results:
@EN The lst course of BCG was successful in 47 (66%) of 71 patients treated for prophylaxis and 3 (50%) of 6 treated for carcinoma in situ. Subsequent progression of disease occured in 6 patients (85) and cystectomy was performed in 2 patients
(3%). The
response rate for the total patients population treated with the lst course was 65% (50% of 77). Of 27 patients who failed the lst treatment course 21 patients were given toe 2nd BCG treatment course. Of the 2nd HCG course, subsedquent
progression
of
disease occured in 3 patients (14%), and cystectomy was performed in 2 patients (9%). Thirteen (68%) had complete response and 5 (26%) had new tumors, who had rendered free of disease after TURB plus intravesical therapy 9mitomycin and/or BCG).
Although
serious GCG complications (hepatitis, miliary Tbc, sepsis) were observed in 2 patients, side-effects were self-limiting and well controlled in the majority of patients (fever, bladder irritability, and hematuria).
@ES Conclusions:
@EN Intravesical BCG therapy seems to be effective to prevent recurrence and progression of superficial bladder cancer with long-term follow-up. However, we must note the possibility of fatal generalized complications in patients with grossly
trauma of
lower urinary tract.
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