Additional bacillus Calmette-Guérin therapy for recurrent transitional cell carcinoma after an initial complete response.
OBJECTIVE
To determine the success of additional bacillus Calmette-Guérin (BCG) therapy for transitional cell carcinoma recurring after a complete response (CR) to the initial treatment course of BCG.


METHODS
All patients treated with BCG with a minimum follow-up of 5 years were reviewed to identify complete responders who subsequently recurred and received additional BCG therapy. The duration of initial response and the incidence and duration of a second CR were recorded.


RESULTS
Of 11 patients with an initial CR to a 6-week course of BCG, 9 (82%) achieved a second CR and 5 of the 9 (42%) maintained tumor-free status beyond 5 years of follow-up (median 87 months, range 64 to 110). Patients who again recurred after the second CR did not benefit from further BCG therapy.


CONCLUSIONS
A repeat course of BCG is a reasonable option of therapy for transitional cell carcinoma that has recurred after a CR to a prior course of BCG. Careful monitoring by cytology, cystoscopy, and biopsy is mandatory to direct nonresponders to prompt alternative therapy and to ensure continued disease-free status among responders.
Bui
T T
TT
Department of Urology, Virginia Prostate Center, Sentara Cancer Institute, Norfolk, Virginia, USA.
Schellhammer
P F
PF
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D012074:Remission Induction; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine