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Intravesical bacillus Calmette-Guérin (Tokyo 172 strain) therapy for carcinoma in situ of the bladder

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Abstract

To evaluate the clinical response to intravesical instillation therapy with bacillus Calmette-Guérin (BCG) Tokyo 172 strain for carcinoma in situ (CIS) of the bladder and subsequent patient prognosis, we reviewed data for 30 patients treated between 1985 and 1994. Median follow-up was 56 months. The CIS cases comprised two groups: primary (19 patients) and subsequent to development of a gross neoplasm (11 patients). Either 40 mg (n=20) or 80 mg (n=10) doses of BCG were instilled weekly for 8 weeks. This intravesical therapy resulted in apparent eradication of tumour cells in 25 of the 30 patients for a complete response (CR) rate of 83%, with no difference found between primary and secondary groups. Tumours later recurred in 6 of the 25 patients (24%) and disease progression was found in only 3 (12%). In contrast, progression occurred in 3 of 5 patients (60%) for which a complete response was not achieved with intravesical BCG therapy. The difference between these two groups was significant (p=0.04). Total cystectomy was performed in 2 of 25 CR patients (8%) first and in 4 of the 5 unresponsive (80%), the statistical difference being highly significant (p=0.003). The 5-year survival rate was 96% for the study subjects as a whole. In conclusion, CIS unresponsive to BCG therapy should be treated with immediate total cystectomy while cases demonstrating a complete response should be followed up for a long period.

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Authors and Affiliations

  1. Department of Urology, Nagoya University School of Medicine, Kasugai Aichi

    M. Takashi & T. Shimoji

  2. Department of Urology, Nagoya First Red-Cross Hospital, Kasugai Aichi

    T. Murase

  3. Department of Urology, Kasugai Municipal Hospital, Kasugai Aichi

    T. Sakata

  4. Department of Urology, Inazawa Municipal Hospital, Inazawa, Aichi

    T. Sobajima

  5. Department of Urology, Tazimi Prefectural Hospital, Tajimi Gifu, Japan

    Y. Suzuki

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  1. M. Takashi
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  2. T. Shimoji
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  3. T. Murase
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  4. T. Sakata
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  5. T. Sobajima
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  6. Y. Suzuki
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Takashi, M., Shimoji, T., Murase, T. et al. Intravesical bacillus Calmette-Guérin (Tokyo 172 strain) therapy for carcinoma in situ of the bladder. International Urology and Nephrology 29, 557–563 (1997). https://doi.org/10.1007/BF02552201

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