title: The response of patients with superficial bladder cancer to a second course of intravesical bacillus Calmette-Guerin.
abstract: Of 347 patients who received an initial 6-week course of intravesical bacillus Calmette-Guerin for superficial transitional cell carcinoma of the bladder 28 (8%) were treated with another course. Subsequent progression of disease (muscle infiltration, metastasis or local progression) occurred in 13 patients (46%). Of the 15 patients (54%) without progression 10 (36%) had a complete response and 5 (33%) had new tumors, and they were rendered free of disease after transurethral resection. The median duration of response to course 1 of bacillus Calmette-Guerin was shorter for patients with disease progression after course 2 than for those with no progression (15 and 27 months, respectively, p equals 0.05). The median followup after course 2 was 31.2 months (range 15.6 to 56.4 months). The median interval between courses 1 and 2 of intravesical bacillus Calmette-Guerin was 21.6 months (range 3.6 to 78.8 months). The interval from course 2 of bacillus Calmette-Guerin to progression correlated with the duration of response to course 1 of treatment (p equals 0.01). It appears that a subsequent treatment with bacillus Calmette-Guerin is most likely to be useful in patients who have a sustained response to the initial treatment.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: P R
authors.initials: PR
authors.lastname: Bretton
authors.forename: H W
authors.initials: HW
authors.lastname: Herr
authors.forename: M
authors.initials: M
authors.lastname: Kimmel
authors.forename: W F
authors.initials: WF
authors.lastname: Whitmore
authors.forename: V
authors.initials: V
authors.lastname: Laudone
authors.forename: H F
authors.initials: HF
authors.lastname: Oettgen
authors.forename: W R
authors.initials: WR
authors.lastname: Fair
mesh_terms: D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D009364:Neoplasm Recurrence, Local; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*
chemical_list: D001500:BCG Vaccine