Percutaneous bacillus Calmette-Guerin perfusion of the upper urinary tract for carcinoma in situ.
Ten pyeloureteral systems in 8 patients (mean age 74 years) with cytologically proved ureteral carcinoma in situ (1 combined with ureteral papillary tumors) were perfused with bacillus Calmette-Guerin via a percutaneous nephrostomy tube. In 4 patients cytology results remained negative after 1 treatment course during an observation time of 18 to 28 months. In 1 patient a papillary tumor persisted while cytology results became negative for carcinoma in situ. Two patients with bilateral disease had repeated perfusion of bacillus Calmette-Guerin until cytology results became negative and they remained negative during observation for 18 months in 1. The other patient had a multifocal recurrence of carcinoma in situ, combined with a stage T1, grade 3 urothelial cancer in the bladder after 12 months and a recurrence of carcinoma in situ in 1 ureter after 24 months. In 1 patient treatment was stopped prematurely after severe septicemia. Although our short-term results are promising, percutaneous perfusion of bacillus Calmette-Guerin for carcinoma in situ of the upper urinary tract should be considered as an investigational treatment modality until long-term results are available.
Studer
U E
UE
Department of Urology, University of Bern, Switzerland.
Casanova
G
G
Kraft
R
R
Zingg
E J
EJ
D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002278:Carcinoma in Situ / Q000628:therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010477:Perfusion / Q000379:methods; D014516:Ureteral Neoplasms / Q000628:therapy*; D014551:Urinary Tract
D001500:BCG Vaccine