Hillyard R W, Ladaga L, Schellhammer P F
Department of Urology, Eastern Virginia Medical School, Norfolk.
J Urol. 1988 Feb;139(2):290-3. doi: 10.1016/s0022-5347(17)42389-5.
Intravesical Pasteur strain bacillus Calmette-Guerin was used to treat 8 patients with mucosal transitional cell carcinoma of the prostatic urethra associated with superficial transitional cell carcinoma of the bladder. Complete initial response in the prostatic urethra was obtained in 7 of the 8 patients. Two patients had progression of disease during intravesical bacillus Calmette-Guerin therapy (1 in the prostate and 1 in the bladder) and they received further surgical therapy. Of the 6 complete responders 1 patient had invasive ureteral, vesical and prostatic tumor 15 months after bacillus Calmette-Guerin therapy, and he underwent nephroureterectomy and cystoprostatourethrectomy. Two patients required additional transurethral therapy for recurrent superficial tumors in the bladder but they have shown no evidence of recurrence in the prostatic urethra. Three patients have remained free of disease at 8 to 36 months. Before radical cystoprostatourethrectomy and urinary diversion are recommended, our study supports a course of bacillus Calmette-Guerin therapy as initial treatment for patients with superficial transitional cell carcinoma of the bladder associated with mucosal involvement of the prostatic urethra.
采用膀胱内灌注巴斯德株卡介苗治疗8例前列腺尿道黏膜移行细胞癌合并膀胱浅表性移行细胞癌的患者。8例患者中有7例前列腺尿道获得了完全初始缓解。2例患者在膀胱内卡介苗治疗期间病情进展（1例在前列腺，1例在膀胱），随后接受了进一步的手术治疗。6例完全缓解者中，1例在卡介苗治疗15个月后发生输尿管、膀胱和前列腺浸润性肿瘤，接受了肾输尿管切除术和膀胱前列腺尿道切除术。2例患者因膀胱浅表性肿瘤复发需要额外的经尿道治疗，但前列腺尿道未显示复发迹象。3例患者在8至36个月时无疾病复发。在推荐行根治性膀胱前列腺尿道切除术和尿流改道之前，我们的研究支持将卡介苗治疗疗程作为膀胱浅表性移行细胞癌合并前列腺尿道黏膜受累患者的初始治疗方法。
