Bladder CIS Extent Predicts Post-BCG Disease Progression

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Int J Urol. 2008; 15:309-313

 

Treatment with bacillus Calmette-Guérin (BCG) is effective for carcinoma in situ (CIS) of the bladder, according to Japanese researchers.

 

Atsushi Takenaka, MD, PhD, of Kobe University Graduate School of Medicine in Kobe, and colleagues studied 185 patients with CIS of the bladder (155 men, 30 women). Of these patients, 75 (40.5%) had limited CIS and 64 (34.6%) had extensive CIS. Patients underwent weekly BCG instillations for eight weeks. The median follow-up period was 37.5 months (range, 4-95 months).

 

The overall complete response rate was 86.5%. Five-year progression-free survival was 78.5%. The extent of CIS was the only independent prognostic factor. Complete responders had a five-year recurrence-free rate of 66%. Ten incomplete responders underwent radical cystectomy during follow-up. Of these, seven had invasive bladder cancer. Thirty patients (16.2%) had extravesical involvement; of these, 21 (11.3%) had upper urinary tract recurrence and nine (4.9%) had prostatic involvement.

 

The investigators concluded that disease progression, including extravesical involvement, should be monitored carefully long-term following BCG therapy.

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