Bladder tumors invading the lamina propria (stage T1): influence of endovesical BCG therapy on recurrence and progression.
We treated 47 patients with transitional cell bladder carcinoma invading the lamina propria (stage T1) from 1984 to 1986 with complete transurethral resection followed by one to three courses of endovesical BCG instillation and followed them for 14-64 months with cystoscopic and endoscopic tests and bladder biopsy. Complete response was achieved in 64%, and 36% had recurrences (recurrence rate per 100 month/patient, 2.2); 21% progressed to muscle invasion. Duration of treatment, tumor size or type (solid versus papillary), and presence of carcinoma in situ bore no relation to the final result. A history of previous T1 bladder tumor appeared associated with a higher risk of progression, although not statistically significantly. The results were compared with those obtained by transurethral resection alone in a similar group of 50 patients treated from 1982 to 1984 and followed for 12 to 100 months. Of these 90%, had recurrence, and 34% progressed to muscle invasion, with a recurrence rate per 100 month/patient of, 9.2. In light of the limits of a non-randomized historical comparison, it appears that endovesical BCG therapy favorably alters the recurrence pattern of T1 bladder cancer.
Dept. of Urology, Hôpital Bichat, Paris, France.
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L
Boccon-Gibod
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C
Leleu
J M
JM
Herve
M
M
Belas
A
A
Steg
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy
D001500:BCG Vaccine