A Clinical Efficacy of Intravesical Bacillus Calmette-Guerin Therapy of Stage T1 Bladder Cancer

Lee, Kyoung Joon; Cho, Yong Hyun; Yoon, Moon Soo

Abstract

The stage T1 lesion, especially when of high grade, is associate with progression to muscle invasion that ranges from 30 to 50%. Therefore, some researchers have recommended treatment with cystectomy. T0 evaluate bacillus Calmette-Guerin (BCG) treatment of the stage T1 high grade lesion we reviewed our complete response rates and compared them with those of treatment of the stage Ta lesion. And we evaluated the influence of the characteristics of stage T1 tumors such as multiplicity, tumor size and grade to the tumor progression. A total of 21 patients with a diagnosis of stage T1 grade II, III bladder cancer was assigned to receive Pasteur strain BCG intravesically weekly for 6 weeks. Local recurrences were treated with repeat transurethral resection followed by additional BCG treatment. The mean followup was 42 months, with a range of 12 to 83 months. Overall, 14 of 21 patients (67%) were free of tumor recurrence with intravesical BCG therapy. This result includes 43% of the patients who responded to the initial transurethral resection and intravesical BCG, and 24% who ceased having tumors after additional treatments for local recurrences. In stage Ta grade II, III lesion, the overall complete response rate was 72% (18 of 25 patients). The characteristics of stage T1 tumors with and without progression were not statistically different in regard to multiplicity, tumor size and grade. In conclusion, our experience demonstrate that BCG therapy is an effective initial treatment of stage T1 lesion to prevent progression and recurrence, and to preserve bladder function.