A Retrospective Analysis of 153 Patients Treated With or Without Intravesical Bacillus Calmette-Guerin for Primary Stage T1 Grade 3 Bladder Cancer: Recurrence, Progression and Survival
2003; Lippincott Williams & Wilkins; Volume: 169; Issue: 1 Linguagem: Inglês
10.1016/s0022-5347(05)64044-x
ISSN1527-3792
AutoresOsama Shahin, George N. Thalmann, Cyrill A. Rentsch, Luca Mazzucchelli, Urs E. Studer,
Tópico(s)Urinary Tract Infections Management
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2003A Retrospective Analysis of 153 Patients Treated With or Without Intravesical Bacillus Calmette-Guerin for Primary Stage T1 Grade 3 Bladder Cancer: Recurrence, Progression and Survival OSAMA SHAHIN, GEORGE N. THALMANN, CYRILL RENTSCH, L. MAZZUCCHELLI, and U.E. STUDER OSAMA SHAHINOSAMA SHAHIN , GEORGE N. THALMANNGEORGE N. THALMANN , CYRILL RENTSCHCYRILL RENTSCH , L. MAZZUCCHELLIL. MAZZUCCHELLI , and U.E. STUDERU.E. STUDER View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64044-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We retrospectively evaluated the long-term outcome in patients with newly diagnosed stage T1 grade 3 bladder cancer treated with transurethral resection with or without intravesical bacillus Calmette-Guerin (BCG). Materials and Methods: Of 153 patients with a median age of 67 years (range 36 to 88) and a male-to-female ratio of 4:1 we treated 92 with transurethral bladder resection and additional BCG, and 61 with transurethral bladder resection alone. BCG was administered intravesically as 120 mg. BCG Pasteur F dissolved in 50 ml. saline, retained for up to 2 hours weekly for 6 weeks and repeated as necessary. Results: Median followup was 5.3 years (range 0.4 to 18.2). Disease recurred in 70% of the patients treated with BCG and in 75% treated with transurethral resection alone. Median time to recurrence was 38 and 22 months for BCG and resection alone (p = 0.19). Tumor progressed in 33% of patients with BCG and in 36% with resection alone. Deferred cystectomy was performed in 29% of the patients with BCG and in 31% with resection alone. Overall and disease specific survival did not differ significantly. Conclusions: Our results suggest that intravesical BCG therapy after transurethral bladder resection for stage T1 grade 3 bladder cancer may delay the time to recurrence and cystectomy but it does not substantially alter the final outcome. Our findings reflect the rule of 30% for stage T1 grade 3 cancer, namely approximately 30% of patients never have recurrence, 30% ultimately die of metastatic disease and 30% require deferred cystectomy. References 1 : Treatment of superficial bladder tumors achievements and needs. The EORTC Genitourinary Group. Eur Urol2000; 37: 1. Crossref, Medline, Google Scholar 2 : Radical cystectomy for high risk patients with superficial bladder cancer in the era of orthotopic urinary reconstruction. Cancer1995; 76: 833. Crossref, Medline, Google Scholar 3 : Stage T1, grade 3 transitional cell carcinoma of the bladder: an unfavorable tumor?. J Urol1984; 137: 39. 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