Bacillus Calmette-Guérin perfusion therapy for carcinoma in situ of the upper urinary tract.
OBJECTIVE
To analyse the clinical and therapeutic consequences of bacillus Calmette-Guérin (BCG) perfusion therapy for carcinoma in situ (CIS) of the upper urinary tract.


METHODS
Eight pyelo-ureteric systems in five patients with cytologically confirmed CIS of the upper urinary tract were treated using perfusion of BCG through a percutaneous nephrostomy tube in five and a retrograde ureteric catheter in three. Follow-up cystoscopy, retrograde pyelography and selective urinary cytology were obtained 4 weeks after the last treatment and every 3 months thereafter.


RESULTS
In three patients (five pyelo-ureteric systems) the cytology remained negative for 10-46 months after the treatment was completed. The remaining two patients (three pyelo-ureteric systems) had persistently positive cytology. Of two patients who received BCG therapy through a ureteric catheter, one developed a ureteric stricture and the other developed renal tuberculosis.


CONCLUSIONS
Although long-term adaptation to a nephrostomy tube disturbs the quality of life of the patient, percutaneous perfusion therapy through a nephrostomy tube seems to be safer than retrograde perfusion through a ureteric catheter.
Yokogi
H
H
Department of Urology, Shimane Medical University, Izumo, Japan.
Wada
Y
Y
Mizutani
M
M
Igawa
M
M
Ishibe
T
T
D000368:Aged; D001500:BCG Vaccine / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000628:therapy*; D001749:Urinary Bladder Neoplasms / Q000628:therapy; D014546:Urinary Catheterization
D001500:BCG Vaccine