Primary bladder carcinoma in situ: assessment of early BCG response as a prognostic factor.
OBJECTIVE
To evaluate the prognosis of primary bladder carcinoma in situ (CIS) according to the response to bacillus Calmette-Guerin (BCG).


METHODS
Twenty-six cases of primary CIS were treated with BCG. Mean, median and minimum follow-up periods were 47, 56 and 24 months. At 6 months, the patients were evaluated endoscopically and the response was classified as complete, partial or failure.


RESULTS
Twenty-one patients (80.8%) showed complete response to BCG, 3 did so after a second course; 28.5% relapsed or progressed at a mean of 44 months. Five patients (19.2%) did not respond initially and all progressed in a period of 6 months. Early response to BCG was the only significant prognostic factor (p < 0.005).


CONCLUSIONS
A high- and a low-risk group of bladder CIS can be differentiated according to the response to BCG. CIS of the bladder has a poor prognosis, and the number of patients who developed progressive disease is significantly higher among the nonresponders.
Orsola
A
A
Department of Urology, Fundación Puigvert, Barcelona, Spain.
Palou
J
J
Xavier
B
B
Algaba
F
F
Salvador
J
J
Vicente
J
J
D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D016001:Confidence Intervals; D003558:Cystoscopy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality