PTU - Polskie Towarzystwo Urologiczne
list of articles:

The results of treatment of patients with stage T1 transitional cell bladder carcinoma after intravesical BCG vaccine infusions
Article published in Urologia Polska 2007/60/4.

authors

Andrzej Alter, Tomasz Demkow, Paweł Wiechno
Oddział Urologii Radomskiego Szpitala Specjalistycznego w Radomiu
Klinika Nowotworów Układu Moczowego, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie w Warszawie

keywords

urinary bladder, bladder carcinoma, intravesical BCG vaccine infusions, treatment effects

summary

Introduction. It is widely regarded that intravesical immunostimulation with the BCG vaccine infusions may effectively prevent recurrence

and progression of the superficial bladder cancer.

The aim of the study. The aim of the study is to asses intravesical BCG vaccine infusions in patients with the superficial bladder cancer (stage T1).

Material and methods. We have observed 78 patients with the diagnosis of stage T1 bladder cancer. The patients after resection received the full cycle of immunostimulation treatment in the form of the intravesical BCG vaccine infusions. The infusions were applied according to Lamm scheme. The follow up cystoscopies were performed every third month during the period of the first year, then from the second to the fifth year twice a year and then annually years.

Results. The lack of recurrence during and after the whole cycle of BCG immunostimulation was observed in 49 patients, which constituted 62.8% of all patients reviewed. The recurrence appeared in 29 patients (37.2%).

Conclusions. Intravesical immunostimulation with the BCG vaccine infusions significantly prevents recurrence and progression of the transitional cell carcinoma infiltrating the submucous membrane.

references

  1. Kirkali Z, Chan T, Manoharan M et al: Bladder cancer: Epidemiology, staging
  2. and grading, and diagnosis. Urology 2005, 66, 4-33.
  3. Coolmon MS, Heer HW, Zhang Z-F et al: The treatet natural history of high risk superficial bladder cancer: 15 year outcome. J Urol 1997, 158, 62-68.
  4. Kaubisch S, Lum BL, Reese J et al: Stage T1 bladder cancer: grade is the primary determitant for risk of muscle invasion. J Urol 1991, 146, 28-31.
  5. Zieger K, Wolf H, Olsen PR, Hojgaard K: Long-term survival of patients with bladder tumours: the significance of risk factors. Br J Urol 1998, 82, 667-672.
  6. Freeman JA, Esrig D, Stein IP et al: Radical cystectomy for high risk patients with superficial bladder cancer in the era of orthotopic urinary reconstruction.
  7. Cancer 1995, 76, 833-839.
  8. Amling CL, Thrasher JB, Frazier HA et al: Radical cystectomy for stages Ta, Tis and T1 transitional cell carcinoma of the bladder. J Urol 1994, 151, 31-35.
  9. Schrier B, Hollander M, van Rhijn. B et al: Prognosis of muscle-invasive bladder cancer: difference between primary and progressive tumours and implications for therapy. Eur Urol 2004, 45, 292-296.
  10. Cookson MS, and Sarosdy MF: Management of stage T1 superficial bladder cancer with intravesical bacillus Calmette – Guerin therapy. J Urol 1992, 148, 797-801.
  11. Brake M, Loertzer H, Horsch R, Keller H: Recurrence and progression of stage T1, grade 3 transitional cell carcinoma of the bladder following intravesical immunotherapy with bacillus Calmette – Guerin. J Urol 2000, 163, 1697-1701.
  12. Holmang S, Hedelin H, Anderstrom C et al: The importance of the depth of invasion in stage T1 bladder carcinoma: a prospective cohort study. J Urol 1997, 157, 810-813.
  13. Bostwick DG, Ramnani D, Cheng L: Diagnosis et grading of bledder cancer and associated lesions. Urol Clin North Am 1999, 26, 493-507.
  14. Góralski A: Algorytmy i programy statystyki kwalitatywnej. WNT Warszawa 1979.
  15. Jakse E, Agaba F, Malmstron PU, Ooesterlinck W: A second – look TUR in T1 transitional cell carcinoma: why? Eur Urol 2004, 45, 539-546.
  16. Brauers A, Buettner R, Jahs G: Second resection and prognosis of primary high risk superficial bladder cancer: is cystectomy often too early? J Urol 2001, 65, 808-810.
  17. Demkow T: Podstawy patogenetyczne działania BCG-terapii powierzchownego
  18. raka pęcherza moczowego. Urol Pol 2005, 2, 99-102.
  19. Hinotsu S, Akaza H, Isaka S et al: Sustainet prophylactis effect of intravesical
  20. bacillus Calmette – Guerin for superficial bladder cancer: a smoothed hazard analysis in a randomized prospective study. Urology 2006, 67, 545-549.
  21. Smits Geert, Schaasfsma E, Kiemeney L et al: Microstaging of pT1 transitional
  22. cell carcinoma of the bladder: identification of subgroups with distinct risks of progression. Urology 1998, 52, 1009-1013.
  23. Orsola A, Trias I, Raventos CX et al: Initial high - grade T1 urothelial cell carcinoma: Feasibility and prognostic significance of lamina propria invasion microstaging (T1a/b/c) in BCG - treated and BCG - non - treated patients. Eur Urol 2005, 48, 231-238.
  24. Kondylis FI, Demirci S, Ladage L et al: Outcomes after intravesical bacillus Calmette – Guerin are not affected by substaging of high grade T1 transitional
  25. cell carcinoma. J Urol 2000, 163, 1120-1123.
  26. Borhan A, Reeder J, O’Connel M et al: Grade progression and regression in recurrent urothelial cancer. J Urol 2003, 169, 2106-2109.
  27. Soloway M, Bruch D, Kim S: Expectant management of small, recurrent, noninvasive papillary bladder tumors. J Urol 2003, 170, 438-441.
  28. Harry W Herr: Tumor progression and survival of patients with high grade, noninvesive papillary (TaG3) bladder tumors: 15year outcome. J Urol 2000, 163, 60-62.
  29. Harry W Herr: Timing of cystectomy for superficial bladder tumors. Urol Oncology 2000, 5, 162-165.
  30. Herr H, Donat M, Bajorin D: Bladder cancer, the limits of surgical excision – when (how much?). Urol Oncology 2001, 6, 221-224.

correspondence

Andrzej Alter
Oddział Urologii Radomskiego Szpitala Specjalistycznego
ul. Tochtermana 1
26-600 Radom
tel. (048) 36 15 100
andrzej-56@o2.pl