INTRAVESICAL BACILLUS-CALMETTE-GUERIN TREATMENT FOR STAGE T1 GRADE 3 TRANSITIONAL-CELL CARCINOMA OF THE BLADDER

Objectives. To retrospectively analyze intravesical bacillus Calmette- Guerin (BCG) treatment for Stage T1 grade 3 (T1G5) transitional cell c arcinoma (TCC) of the bladder. Methods. Between 1984 and 1995, 78 pati ents with Stage T1 grade 3 tumor were treated by transurethral resecti on of all visible tumors and adjuvant BCC intravesical instillations. Median follow-up was 56 months (range 12 to 141). Results. After an in itial induction course, 52 patients (67%) were tumor-free. Twenty-two patients (28%) had recurrent tumor after a median of 7 months (range 5 to 62). Progression occurred in 6 patients (7.7%) after a median of 1 8 months (range 5 to 56). Conclusions. Intravesical BCG appears to be an effective treatment for patients with Stage T1 grade 3 TCC. Patient s whose tumors recur after an initial induction course may benefit fro m a second course of BCG. Intravesical BCC treatment may lower the tum or progression rate. Late recurrence, beyond 2 years, warrants long-te rm follow-up. (C) 1998, Elsevier Science Inc. All rights reserved.