Superficial Bladder Carcinoma Treated with Bacillus Calmette-Guerin: Minimum 5-year Follow up Results

Park, Jong Wook; Park, Choal Hee; Kim, Chun Il

Abstract

PURPOSE: The long-term outcome of intravesical Bacillus Calmette-Guerin (BCG) therapy for superficial bladder cancer is not well known. We evaluated the results of minimum 5 year follow up of superficial bladder cancer patients who were treated with transurethral resection (TUR) combined with intravesical BCG therapy.
MATERIALS AND METHODS
Between July 1985 and June 1997, 120 patients with superficial bladder cancer were treated with TUR and intravesical BCG, and were followed for at least 5 years. The mean follow-up duration was 87 months. Thirty-eight patients had Ta tumors, 60 T1 and 22 CIS. The tumor grades were I, II and III, by the WHO grading, in 24, 65 and 31 patients, respectively.
RESULTS
Of the 120 patients, the tumor recurred in 44 and progressed in 19, at a median of 12 and 28 months, respectively. Thirty-one (70.5%) of the recurrences and 16 (85%) of the progressions were found within 5 years of the BCG. The complete responses after first and second courses of BCG were 92 and 100% in Ta, 60 and 33% in T1 and 52 and 55% in CIS, respectively. The 5 and 10 year progression free survival rates, and disease specific survival rates, were 89.8 and 70.3%, and 85.1 and 76%, respectively. Twenty-two died of bladder cancer.
CONCLUSIONS
TUR and intravesical BCG are successful in controlling the majority of superficial bladder cancers in long-term follow-up. Most of recurrences and progressions developed within 5 years of the BCG, but a significant numbers of recurrences occurred after 5 years. Therefore, close follow-up is still needed at over 5 years after BCG therapy.