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Analysis of efficacy of maintenance BCG therapy in the treatment of intermediate and high risk superficial bladder cancers
Article published in Urologia Polska 2004/57/1.

authors

Anna Kołodziej, Janusz Dembowski, Romuald Zdrojowy, Tomasz Szydełko, Tadeusz Niezgoda, Michał Wróbel, Paweł Kowal, Jerzy Lorenz
Katedra i Klinika Urologii Akademii Medycznej we Wrocławiu
Kierownik kliniki: prof. dr hab. Jerzy Lorenz

keywords

bladder, transitional cell carcinoma, BCG therapy

summary

introduction
The impact of intravesical immunotherapy BCG on the incidence of radical cystectomy in intermediate and high-risk superficial bladder cancer remains controversial.
For this purpose we retrospectively evaluated the long-term outcome in patients with stage Ta/T1 grade 2/3 bladder cancer treated with transurethral resection with or without intravesical bacillus Calmette-Guerin.
materials and methods
Of 263 patients with median age of 67 years (range 36-88), 134 and 129 were treated with TURB with adjuvant BCG (maintenance schedule) and with TURB alone respectively.
results
Median followup was 56,2 months (range 87-11). Disease recurred in 22,3% patients treated with BCG, with median time to recurrence of 15,8 months and in 54,7% patients treated with transurethral resection alone with median time to recurrence of 8 months. Tumor progressed in 12,7% of patients with BCG and in 24% with resection alone. Deferred cystectomy was performed in 11,1% patients with BCG and in 26,3 % with resection alone. Median time to cystectomy was 33 months in BCG group and 8,4 months in control group. Disease specific survival also differed significantly (2,9% versus 26,3% respectively).
conclusions
Our results suggest that intravesical BCG therapy-maintenance schedule - after TURB for intermediate/high-risk bladder cancer may delay the time to recurrence, progression and cystectomy what really alter the prognosis for patients with this disease.

references

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correspondence

Anna Kołodziej
Klinika Urologii AM
pl. 1 Maja 8
50-043 Wroclaw
tel: (O...71) 34 347 59