RISK OF COMPLICATIONS WITH ENDOVESICAL BCG THERAPY FOR SUPERFICIAL BLADDER-TUMORS

OBJECTIVES: BCC therapy is the reference adjuvant treatment for multip le and voluminous or recurrent superficial bladder cancer and can caus e specific complications. We assessed the frequency and therapeutic mo dalities involved associated with such complications in a personal ret rospective series of patients. PATIENTS AND METHODS: BCC therapy was g iven to 148 patients who were followed for a mean 40 months. RESULTS: Forty-six percent of the patients developed a follicular reaction in t he bladder wall: 14 developed complications requiring anti-tuberculosi s treatment The frequency of BCC therapy complications was higher in p atients who had had tuberculosis previously (50%) than those who did n ot (13.8%). Complications were more frequent after early treatment in the patients who developed BCGitis with fever, a 3-month regimen of ri fampicin and isoniazine appeared to be sufficient DISCUSSION: The freq uency of BCC therapy complications (bladder anomalies excluded) was 78 % with only 2.8% major complications. The development of a follicular reaction of the bladder Wall does not appear to have any prognostic va lue. Special surveillance is needed in patients with a past history of tuberculosis. CONCLUSION: Adjuvant BCC therapy requires careful follo w-up because of the risk of BCGitis which can be effectively treated w ith a 3-month double-antibiotic regimen.