title: [Recurrent bladder cancer after BCG instillation therapy. Local therapy options?].
abstract: Patients with a so-called BCG failure (Bacillus Calmette-Guérin) constitute an inhomogeneous group of patients. Patients with BCG recurrence or BCG refractive tumors are real BCG failures. Therapeutic options are radical cystectomy and a conservative approach, depending on the individual risk of recurrence and progression. Intravesical chemotherapy with docetaxel or gemcitabine after BCG failure shows some promise whereas second line immunotherapy, the combination of BCG and interferon (INF)-α, is an effective regimen but results need to be confirmed. Device-assisted intravesical strategies, such as mitomycin-EMDA or chemohyperthermia are candidates to keep in mind for the near future. Finally, cystectomy results in the best disease-specific survival in patients with BCG failure.
authors.affiliation: Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein - Campus Luebeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. Jan.Laturnus@uk-sh.de
authors.forename: J M
authors.initials: JM
authors.lastname: Laturnus
authors.forename: D
authors.initials: D
authors.lastname: Jocham
authors.forename: M
authors.initials: M
authors.lastname: Sommerauer
mesh_terms: D001500:BCG Vaccine / Q000627:therapeutic use*; D015653:Cystectomy / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000401:mortality*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000517:prevention & control*
chemical_list: D001500:BCG Vaccine