INTRAVESICAL BACILLE CALMETTE-GUERIN THERAPY FOR MUSCLE INVASIVE BLADDER-CANCER

Objectives. This investigation attempted to determine whether the degr ee of fibronectin expression in the bladders of patients with invasive transitional cell carcinoma correlated with their clinical response t o intravesical bacille Calmette-Guerin (BCC) therapy, Methods. Followi ng transurethral resection of all invasive disease, 13 patients with S tages T2-T4 bladder cancer were administered intravesical BCG (for 6 w eeks followed by monthly instillations), Fibronectin expression in the patients' resected tumors and normal mucosa was determined by immunoh istochemical staining techniques. Minimum disease-free follow-up was 6 0 months. Results. Only 1 of 13 patients had neither local nor systemi c disease recurrence; 10 of 13 patients developed systemic disease and 7 patients died from metastases. Fibronectin expression was nor corre lated with the clinical response to BCG. Conclusions. Intravesical BCC therapy for the treatment of muscle invasive transitional cell carcin oma of the bladder is ineffective. Fibronectin expression in the bladd er of patients with invasive disease is variable and does not correlat e significantly With the clinical response to BCG therapy.