Prophylactic effect of intravesical BCG therapy in superficial bladder cancer

Chai, Ho Cheol; Park, Choal Hee; Lee, Sung Choon

Abstract

Intravesical Bacillus Calmette-Guerin (BCG) had been shown to be effective therapy and prophylaxis against recurrent tumor in patients with superficial bladder cancer, including carcinoma in situ. A study was performed to determine the prophylactic efficacy of intravesical Tice-Chicago strain BCG instillation in 47 patients with high risk superficial bladder cancers (stage Ta or T1). Group I consisted of 17 patients with a history of at least 1 tumor recurrence before BCG therapy. Most had received various forms of intravesical chemotherapy as prophylaxis following previous TUR of the bladder tumor. The tumor recurrence rate of patients was compared with the rate during the 2 years prior to BCG therapy as a personal historical control. The simple recurrence rate of group I was 41.2% before and 5.9% after intravesical BCG therapy. According to the person-years method. the number of recurrent tumors per patient-months was 0.0149 before and 0.0021 after BCG therapy(p>0.05). Group R consisted of 30 consecutive new patients. The tumor recurrence rate after BCG therapy was compared with that of historical controls in our hospital. There were lI6 other patients who had previously been treated by transurethral resection and most had also received intravesical chemotherapy. The simple recurrence rate was 20% in BCG patients and 44.8% in the historical controls. According to the person-years method, the number of recurrences per patient-months in this group was 0.0081 and 0.0576 in the historical group. The results show that intravesical BCG instillation is effective and safe as a prophylaxis against the recurrence of the superficial bladder tumors. The granulomatous response in the bladder and PPD responsiveness have their statistical correlation with status free of tumor.