Intravesical bacillus Calmette-Guerin (BCG) instillation for primary and recurring T1G3 bladder cancers.

INSTRUCTION

With T1G3 bladder cancer, it remains unresolved whether the best treatment option is bladder preservation or total cystectomy. To assess the feasibility of the first option, we performed a clinical evaluation of the efficacy of intravesical instillation of bacillus Calmette-Guerin (BCG) for prevention of T1G3 bladder cancer recurrence after transurethral resection of bladder tumor (TUR-Bt).

METHODS

A total of 30 patients with T1G3 bladder cancers received 6 to 8 weekly instillations of BCG followed in some cases by further applications at monthly intervals.

RESULTS

Recurrence occurred in 13 cases. There were 6 patients with progression, total cystectomy being performed for 5 of these. Further BCG-including treatments were performed in 7 patients, and all of them were alive at the end of the follow-up period. Finally, bladder preservation proved successful in 24 of 30 cases.

CONCLUSION

Intravesical instillation of BCG in high-risk T1G3 cases, including additional BCG treatment, proved effective and satisfactory in our series. Therefore, this option warrants emphasis with regard to its relative merit compared to total cystectomy.