title: Management of BCG failures in superficial bladder cancer: a review.
abstract: OBJECTIVE
  Review management of bacillus Calmette-Guérin (BCG) failures in superficial bladder cancer.
  
  
  METHODS
  Search of published literature and meeting abstracts.
  
  
  RESULTS
  Patients in whom BCG fails are not a uniform group. Failure cannot be predicted but high-risk patients can be identified. In case of failure and progression the outcome is bad. Conservative but investigative alternatives are BCG/interferon-alpha, intravesical hyperthermia/chemotherapy, or photodynamic therapy. Standard treatment in failing patients remains cystoprostatectomy.
  
  
  CONCLUSIONS
  BCG failures need careful and individualized therapy in experienced hands.
authors.affiliation: Department of Urology, University Medical Centre St. Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. F.Witjes@uro.umcn.nl
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Witjes
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use*; D015653:Cystectomy; D003657:Decision Making; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000601:surgery; D010778:Photochemotherapy; D011379:Prognosis; D017211:Treatment Failure; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine