Prophylactic Efficacy of Intravesical Bacillus Calmette-Guerin for High Risk Superficial Bladder Tumor

Kim, Hyeong Gon; Kim, Hyun Hoe; Lee, Eun Sik; Lee, Chong wook

Abstract

A study was performed to determine the prophylactic efficacy of intravesical BCG instillation in 82 patients with high risk superficial bladder tumors. Recurrent, grade III, multiple(more than 3) or large(more than 3cm) stage Ta orT1 tumors were included. They were treated with 6 weekly instillation of 120mg of BCG after transurethral resection. Another thirty six patients treated with transurethral resection alone were selected as a control group. All the patients were followed more than 24 months, with the mean of 32 months. The one year recurrence rate was 54% in BCG group and 74% in controls, which was statistically different(p<0.05, by Chi-square test), but two year recurrence rate was 71% in BCG group and 82% in controls, which was not statistically different (p>0.05). The median interval of recurrence from treatment was l4.5 months in the BCG group which was longer than that of 7 months in controls and the recurrence per l00 patient months was 7.86 and l4. 68(p<0.05), respectively. In 56 patients with recurrent tumors after BCG treatment, the tumor stage, grade, number and size of the recurrent tumors were lowered significantly compared to the initial tumors (p<0.05). One patient of the BCG group and 3 of the controls had recurrent tumors with progression to muscle invasion. In summary, BCG instillation improved stage and grade, decreased number and size of the recurrent tumors, and delayed the time of recurrence in patients with high risk superficial bladder tumors. Also the overall one year recurrence rate was significantly improved. but two year recurrence rate was not significantly improved.