[Treatment of patients with recurrent superficial bladder cancer with lyophilized Moureau-Rio de Janeiro BCG strain. Brazillian National Cancer Institute experience].
OBJECTIVE
We present our experience with lyophilized Moureau-Rio de Janeiro BCG strain for treatment of patients with recurrent superficial bladder cancer.


METHODS
From October 1986 to January 2001, 114 patients were treated by transurethral resection followed by intravesical instillation of BCG at our institution. Follow-up ranged from 10 to 144 months (mean 50.16 months). The treatment included 6 inductions and 10 maintenance cycles of BCG instillations. The patients received an initial dose with 40 mg and subsequent doses with 80 mg of lyophilized Moureau-Rio de Janeiro BCG strain. Chi-square and Mantel-Haenszel test, with 95% significance, were used to evaluate possible associations among variables. The Kaplan-Meyer method was used to evaluate the disease-free survival rates while log-rank test was used to compare curves among the groups.


RESULTS
Overall recurrence and progression rates after treatment were 45.6% and 13%, respectively. Four patients (3.5%) had complications following BCG instillations. Three of them had to be treated with antituberculous therapy. These patients presented pulmonary disease, granulomatous prostatitis and epididymo-orchitis respectively.


CONCLUSIONS
Moureau-Rio de Janeiro BCG strain was overall well tolerated in intravesical instillations, similar to other strains used in literature. Recurrence rates were decreased with adjuvant BCG therapy. Tumor size, grade and presence of associated carcinoma in situ provided predictive information regarding the behavior of recurrent superficial tumors. The WHO/ISUP classification when compared with tumor grade was superior in selecting patients with high risk of progression.
Quirino
Raul
R
Département d'Urologie, Institut National du Cancer, Rio de Janeiro, Brésil.
Ornellas
Antonio Augusto
AA
Wisnescky
Aristoteles
A
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine