LONG-TERM FOLLOW-UP OF PRIMARY-CARCINOMA IN-SITU OF THE BLADDER

We analyzed 10 patients with primary carcinoma in situ of the bladder whose follow-up period is longer than 5 years. They had neither past h istory of bladder cancer nor overt tumor in cystoscopy. Most patients complained of irritative vesical symptoms such as painful urination an d pollakisuria. Primary cystectomy was performed in 4 patients and pri mary intravesical chemotherapy or immunotherapy was performed in 6 pat ients. When invasive bladder cancer developed in patients undergoing p rimary intravesical chemotherapy or immunotherapy, secondary cystectom y was performed. In all 4 patients undergoing intravesical chemothrapy , invasive bladder cancer developed 6 months to 3 years later. Also in 2 patients undergoing intravesical immunotherapy with bacillus Calmet te-Guerin, invasive bladder cancer developed 2 years and 7 years later . Thus, eventually every patient needed cystectomy. Invasion occurred into the bladder wall in 3 patients, into the prostate in Z patients, and into both bladder wall and prostate in 1 patient. Although intrave sical BCG therapy is the first line treatment for patients with CIS of the bladder, close follow-up is necessary and timely cystectomy is re commended when tumor progression is suspected.