BACILLUS-CALMETTE-GUERIN IN THE TREATMENT OF STAGE T1 GRADE-3 TRANSITIONAL-CELL CARCINOMA OF THE BLADDER - LONG-TERM RESULTS

Purpose: We performed a retrospective long-term study to evaluate the results of immunotherapy in the treatment of high grade superficial bl adder tumors. Materials and Methods: Between 1981 and 1993, 593 patien ts with superficial transitional cell carcinoma of the bladder underwe nt transurethral resection. Of 64 patients with stage T1 grade 3 disea se 50 received intravesical bacillus Calmette-Guerin after transurethr al resection of all visible tumor. Results: At a median followup of 42 months (range 12 to 112) 36 patients (72%) are disease-free and have not required further treatment. Superficial recurrence was noted in 8 patients (16%). Disease progressed in 6 patients (12%), including 5 wi th locally invasive and 1 with metastatic disease. Cystectomy was perf ormed for progression in 4 patients and for recurrent stage T1 grade 3 disease in 1. There was 1 disease related death (2%). The overall sur vival rate is 94%. Conclusions: Intravesical bacillus Calmette-Guerin appears to be the most effective conservative treatment for patients w ith stage T1 grade 3 bladder cancer.