title: [Long-term outcome of initial treatment with Bacillus Calmette-Guérin for carcinoma in situ of the upper urinary tract].
abstract: To assess appropriate treatment strategies for transitional cell carcinoma in situ (CIS) of the upper urinary tract (UUT), we evaluated the long-term outcome of Bacillus Calmette-Guérin (BCG) perfusion therapy for CIS of UUT. We retrospectively reviewed the medical records of 24 patients who underwent BCG perfusion therapy for CIS of UUT between August 1993 and August 2009. Patients received at least one course of BCG (once weekly for 6 weeks). The median follow-up period was 48.5 months (range 16-201 months). In 23 patients (96%), cytology became negative after one course of BCG perfusion and 12 patients (50%) remained disease-free for a median follow-up of 38. 5 months. In 11 patients positive cytology recurred, and in five of them nephroureterectomy was performed after radiologic studies showed the presence of a tumor in the UUT. Histopathology showed invasive tumor (pT3) in all cases, and three of them experienced distant metastases after surgery. In conclusion, BCG perfusion therapy is effective for the treatment of CIS of UUT with long-term follow-up. However, in cases with a poor response or recurrence of CIS, there is a high risk of developing invasive tumor. Surgical intervention should be immediately considered in such cases after the first course of BCG perfusion therapy.
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soda
authors.forename: Kei
authors.initials: K
authors.lastname: Mizuno
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Shotaro
authors.initials: S
authors.lastname: Nakanishi
authors.forename: Seiji
authors.initials: S
authors.lastname: Asai
authors.forename: Rikiya
authors.initials: R
authors.lastname: Taoka
authors.forename: Koji
authors.initials: K
authors.lastname: Inoue
authors.forename: Akito
authors.initials: A
authors.lastname: Terai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000601:surgery / Q000628:therapy*; D002295:Carcinoma, Transitional Cell / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis; D010477:Perfusion; D012189:Retrospective Studies; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000601:surgery / Q000628:therapy*