Demkow Tomasz, Alter Andrzej, Wiechno Paweł
Department of Urology, Institute of Oncology, Warsaw, Poland.
Urol Int. 2008;80(1):74-9. doi: 10.1159/000111734. Epub 2008 Jan 18.
The management of transitional bladder cancer, which invades the lamina propria (pT1) and has a marked propensity for recurrence and progression, is controversial. Without adjuvant treatment the recurrence rate can be up to 80% and progression up to 50%. We retrospectively analyzed the incidence of recurrence and progression of pT1 transitional bladder cancer (grade 1-3) after complete transurethral resection of a bladder tumor (TURBT) and adjuvant immunotherapy with bacillus Calmette-Guérin (BCG).
77 patients with stage pT1 transitional cell carcinoma underwent TURBT of all visible tumors and adjuvant BCG intravesical instillations. Before BCG therapy, 12 patients presented with stage pT1 G1 tumors, 50 presented with pT1, and 15 with pT1 G3 tumors.
51 patients (66.2%) were disease-free throughout the BCG instillation and follow-up period (median of 45 months); 8 patients (10.4%) experienced recurrence during the BCG instillations, but were disease-free following the last instillation; 16 patients (20.8%) experienced recurrence at a median of 17 months, and 2 patients (2.6%) with pT1 G3 died because of progression.
Adjuvant intravesical BCG therapy following TURBT appears to be an effective primary treatment for patients with pT1 transitional cell carcinoma.
浸润固有层的移行性膀胱癌（pT1）具有显著的复发和进展倾向，其治疗存在争议。若不进行辅助治疗，复发率可达80%，进展率可达50%。我们回顾性分析了膀胱肿瘤经尿道完全切除术（TURBT）及卡介苗（BCG）辅助免疫治疗后pT1期移行性膀胱癌（1 - 3级）的复发和进展发生率。
77例pT1期移行细胞癌患者接受了所有可见肿瘤的TURBT及BCG膀胱内灌注。在BCG治疗前，12例患者为pT1 G1期肿瘤，50例为pT1期，15例为pT1 G3期肿瘤。
51例患者（66.2%）在BCG灌注及随访期间（中位时间45个月）无疾病进展；8例患者（10.4%）在BCG灌注期间复发，但在最后一次灌注后无疾病进展；16例患者（20.8%）在中位时间17个月时复发，2例pT1 G3期患者因疾病进展死亡。
TURBT后辅助膀胱内BCG治疗似乎是pT1期移行细胞癌患者有效的初始治疗方法。
