Bacillus Calmette-Guérin therapy alters the progression of superficial bladder cancer.
The effectiveness of BCG in preventing disease progression in patients with superficial bladder cancer is evaluated. Long-term follow-up of high-risk patients treated in a previously reported randomized control trial of intravesical plus percutaneous BCG shows that progression occurred in 41/43 (95%) of control and 23/43 (53%) of BCG-treated patients. Muscle invasive and/or metastatic disease occurred with equal frequency in the two groups, but was significantly delayed by BCG treatment (P = .012). Cystectomies were required in 18/43 (42%) control and 11/43 (26%) BCG-treated patients. Median time to cystectomy was 8 months for control v 24 months for BCG-treated patients. Based on initial treatment, survival was improved by BCG therapy (P = .032) (median follow-up 6 years). These results suggest that in high-risk patients intravesical BCG can delay disease progression, prolong the period of bladder preservation, and increase overall survival.
Herr
H W
HW
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York.
Laudone
V P
VP
Badalament
R A
RA
Oettgen
H F
HF
Sogani
P C
PC
Freedman
B D
BD
Melamed
M R
MR
Whitmore
W F
WF
D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000401:mortality / Q000628:therapy*; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000628:therapy*
D001500:BCG Vaccine