Abstract
Sixty-two patients with superficial bladder cancer stage T1 with or without dysplasia or carcinoma in situ and 34 patients with stage TA associated with dysplasia or carcinoma in situ were treated by TUR and TUR+BCG, respectively, and were followed up for an average of 46 months (6–192) and 32 months (6–72), respectively, after therapy. The recurrence rate (61%), progression (37%) and tumour death (19%) were unfavourably high in the group of patients treated by TUR only. On the contrary, the effect of intravesical BCG therapy was excellent. Recurrence rate was as low as 20.5%, and progression and tumour death were not detected in any patient. Intravesical BCG seems to be the best choice for treatment of high risk superficial bladder cancer. The authors recommend their effective modified treatment schedules.
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Abel, P. D., Hall, R. R., Williams, G.: Should pT1 TCC of bladder still be classified as a superficial.Br. J. Urol., 62, 103 (1988).
Adolphs, H. D., Bastian, H. P.: Chemoimmunoprophylaxis of superficial bladder tumors.J. Urol., 129, 29 (1983).
Baccon-Gibod, L. B., Lelev, I. M., Herve, I. M., Belas, M., Steg, A.: Bladder tumours invading the lamina propria (State: T1): Influence of endovesical BCG therapy on recurrence. In: EORTC Genitourinary Group Monograph 6. Alan R. Liss, Inc., New York 1989, p. 161.
Brosman, S.: The influence of Tice Strain BCG treatment in patients with transitional cell carcinoma in situ. In: EORTC Genitourinary Group Monograph 6. Alan R. Liss, Inc., New York, 1989, p. 193.
England, H. R., Paris, A. M., Blandy, J. B.: The correlation of T1 bladder tumour history with prognosis and follow up requirements.Br. J. Urol., 53, 593 (1981).
Giesbergs, A. G. M., van Helsdingen, I. R. O., Kramer, A. I. L.: Recurrence of superficial bladder carcinoma after intravesical instillation of Mitomycin-C.Br. J. Urol., 63, 176 (1989).
Guinan, P., Crispen, R., Rubinstein, M.: BCG in management of superficial bladder cancer.Urology, 30, 515 (1987).
Heney, N. M., Nocks, I. I., Daly, G. R., Prout, I. R., Newall, J. B., Griffin, P. P., Perrone, T. L., Szyfelbin, W. A.: TA and T1 bladder cancer: Location, recurrence and progression.Br. J. Urol., 54, 152 (1982).
Herr, H. W., Lavdone, V. P., Badalment, P. A., Freedman, B. D., Whitmore, W. F.: BCG therapy alters progression of superficial bladder cancer. Part 2.J. Urol., 139, 299A (1988).
Jakse, G., Loidl, W., Seeber, G., Hofstadter, F.: Stage T1, grade 3 transitional cell carcinoma of bladder: An unfavorable tumor?J. Urol., 137, 39 (1987).
Jauhianen, K., Alfthan, O.: Instillation of Mitomycin-C and Doxorubicin in the prevention of recurrent superficial (TA-T1) bladder cancer.Br. J. Urol., 60, 54 (1987).
Khanna, O. M. P., Son, D. L., Mazer, H., Read, J., Nugent, D., Cattone, R., Heeg, M., Rezvan, M., Viek, N., Friedmann, M.: Superficial bladder cancer treated by intravesical BCG or Adriamycin.J. Urol., 30, 520 (1987).
Koss, L. G.: Diagnostic value of cytology of voided urine.Acta Cytol., 27, 910 (1985).
Malmström, P., Busch, Ch., Norlén, B. J.: Recurrence, progression and survival in bladder cancer.Scand. J. Urol. Nephrol., 210, 185 (1987).
Martinez-Pineiro, J. A., Leon, J. J., Martinez-Pineiro, L., Fiter, L., Mosterio, J. A. Navarro, J., Garcia Matres, M. J., Carcamo, P.: BCG versus doxorubicin versus Thiotepa: a randomized prospective study.J. Urol., 143, 502 (1990).
Morales, A. D., Eidinger, A., Bruce, W.: Intracavitary BCG in the treatment of superficial bladder tumors.J. Urol., 116, 180 (1976).
Pasandro, V., De Paula, F.: Intravesical BCG in the treatment of superficial TCC of the bladder.J. Urol., 138, 299 (1987).
Reitsma, D. J., Guinan, P., Lamm, D. L., Khanna, O. P., Brosman, S. A., DeKernion, J. B., Williams, R. D., Simpson, G., Hanna, M. G.: Long-term effect of intravesical BCG Tise Strain on flat carcinoma in situ of the bladder. In: EORTC Genitourinary Group Monograph 6. Alan R. Liss, Inc., New York 1989, p. 171.
Rübben, H., Lutzeyer, W., Fischer, N., Deutz, F., Lagrange, W., Giani, G.: Natural history and treatment of low and high risk superficial bladder tumors.J. Urol., 139, 283 (1988).
Sarosdy, M. F., Lamm, D. L.: Long term results of intravesical BCG therapy for superficial bladder cancer.J. Urol., 142, 719 (1989).
Schade, R. O. K., Swinney, I.: The association of urothelial abnormalities with neoplasia: A 10-year followup.J. Urol., 129, 1125 (1983).
Smith, G., Elton, R. A., Chisholm, G. D., Newsam, J. E., Hargreave, T. B.: Superifical bladder cancer: intravesical chemotherapy and tumour progression to muscle invasion or metastases.Br. J. Urol., 58, 659 (1986).
Soloway, M. S., Perry, A.: BCG for treatment of superficial TCC of bladder in patients who have failed thiotepa and/or mitomycin-C.J. Urol., 137, 871 (1987).
Stanisic, T. H., Donovan, J. M., Lebouton, J., Graham, A. R.: 5-year experience with intravesical therapy of carcinoma in situ: An inquiry into risk of “conservative” management.J. Urol., 138, 1158 (1987).
Steg, A., Belas, M., Lelev, Ch., Baccon-Gibod, L.: Intravesical BCG therapy in patients with superficial bladder tumors. In: EORTC Genitourinary Group Monograph 6. Alan R. Liss, Inc., New York 1989, p. 153.
Stricker, P. D., Grant, A. B. F., Hasken, B. M., Taylor, I. S.: Topical mitomycin-C therapy for carcinoma in situ of bladder: A follow up.J. Urol., 143, 34 (1990).
Wolf, H., Hojgaard, K.: Urothelial dysplasia concomitant with bladder tumours as a determinant factor for future new occurrences.Lancet, 134 (1983).
Zincke, H., Utz, D. C., Farrow, G. M.: Review of Mayo Clinic experience with carcinoma in situ.Urology,26, Suppl. 39 (1985).
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Samodai, L., Kiss, L., Kolozsy, Z. et al. The efficacy of intravesical BCG in the treatment of patients with high risk superficial bladder cancer. International Urology and Nephrology 23, 559–567 (1991). https://doi.org/10.1007/BF02549846
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DOI: https://doi.org/10.1007/BF02549846