title: Defining bacillus Calmette-Guerin refractory superficial bladder tumors.
abstract: OBJECTIVE
  We define bacillus Calmette-Guerin (BCG) refractory, high risk, superficial bladder cancer.
  
  
  METHODS
  A total of 93 patients received a 6-week induction course of BCG. They were evaluated for response after 3 and 6 months. Half of the patients received monthly maintenance BCG for 2 years and half did not. In both groups the initial responses to BCG at 3 and 6 months were correlated with subsequent tumor recurrence and progression.
  
  
  RESULTS
  Of the 93 cases 57% were negative for tumor at 3 months and 43% had residual tumor resected. At 6 months 80% of the patients were tumor-free and 20% had persistent or recurrent tumor. Maintenance BCG did not decrease tumor recurrence further than induction BCG. Subsequent tumor-free interval during 24 months of followup were best predicted by response to BCG after 6 months.
  
  
  CONCLUSIONS
  A minimum treatment and followup time of 6 months is required to identify high risk, superficial bladder tumors as truly BCG refractory.
authors.affiliation: Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Harry W
authors.initials: HW
authors.lastname: Herr
authors.forename: Guido
authors.initials: G
authors.lastname: Dalbagni
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use*; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D006801:Humans; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine