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Primary Bladder Carcinoma in situ: Assessment of Early BCG Response as a Prognostic Factor

1998; Elsevier BV; Volume: 33; Issue: 5 Linguagem: Inglês

10.1159/000019635

1873-7560

Anna Orsola, Joan Palou, B. Xavier, Ferrán Algaba, Jorge A. R. Salvador, J. Vicente,

Epigenetics and DNA Methylation

Objectives: To evaluate the prognosis of primary bladder carcinoma in situ (CIS) according to the response to bacillus Calmette-Guérin (BCG). Patients and Methods: Twenty-six cases of primary CIS were treated with BCG. Mean, median and minimum follow-up periods were 47, 56 and 24 months. At 6 months, the patients were evaluated endoscopically and the response was classified as complete, partial or failure. Results: Twenty-one patients (80.8%) showed complete response to BCG, 3 did so after a second course; 28.5% relapsed or progressed at a mean of 44 months. Five patients (19.2%) did not respond initially and all progressed in a period of 6 months. Early response to BCG was the only significant prognostic factor (p < 0.005). Conclusions: A high- and a low-risk group of bladder CIS can be differentiated according to the response to BCG. CIS of the bladder has a poor prognosis, and the number of patients who developed progressive disease is significantly higher among the nonresponders.