Bacille Calmette‐Guérin in superficial transitional cell carcinoma

Mungan, N.A.; Witjes, J.A.

doi:10.1046/j.1464-410x.1998.00720.x

Cited by 56 publications

(27 citation statements)

References 107 publications

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“…2 However, only a few studies have analyzed the efficacy of BCG therapy for CIS of the upper urinary tract. [3][4][5][6][7][8][9][10][11][12] Therefore, several points need to be elucidated, especially the most appropriate therapeutic strategy in patients with a poor response or recurrence of CIS after intrarenal BCG therapy.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of bacillus Calmette‐Guérin perfusion therapy for carcinoma in situ of the upper urinary tract

et al. 2002

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Background : The objective of this study was to evaluate the efficacy of intrarenal bacillus CalmetteGuérin (BCG) instillation for the treatment of carcinoma in situ (CIS) of the upper urinary tract. Methods : Sixteen patients who were diagnosed as having CIS of the upper urinary tract were treated with intrarenal BCG instillation. BCG (80 mg) in normal saline was administered once weekly, 6 times in total as one course through a percutaneous nephrostomy tube in 5 patients, and a retrograde ureteric catheterization using a Single-J or Double-J stent in 2 and 9 patients, respectively. Results : During the median follow-up period of 30 months (range: 9-90 months), no patients died, and 13 patients remained cytologically negative in urine collected from the upper urinary tract after BCG treatment was completed. However, one of these 13 patients had CIS in the bladder and prostatic urethra 34 months after the BCG therapy and had to undergo radical cystectomy. The remaining 3 patients experienced recurrence in the upper urinary tract 4, 8, and 11 months after treatment, despite a favorable response to the initial BCG instillation. Of these 3 patients, one patient received an additional course of BCG therapy, while the remaining 2 underwent nephroureterectomy. Bladder irritability or a fever higher than 38 ∞ C was observed in 12 or 9 patients, respectively; however, such side-effects were not clinically significant, and no patient received antitubercular treatment. Conclusion : Intrarenal instillation of BCG appears to be effective and safe for treatment of CIS of the upper urinary tract; however, further experience and longer follow-up studies of this treatment are required.

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Section: Introductionmentioning

confidence: 99%

Clinical outcome of bacillus Calmette‐Guérin perfusion therapy for carcinoma in situ of the upper urinary tract

et al. 2002

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“…Several investigators have since obtained favourable results with BCG in preventing and treating high-risk super®cial bladder tumours (pT1, CIS) [7,8]. Although BCG may be the adjunctive treatment of choice for super®cial bladder tumours, its mechanisms of action are unknown.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cellular tumour rejection mechanisms in the peritumoral bladder wall after bacillus Calmette‐Guérin treatment

Saint¹,

Patard²,

Muscatelli³

et al. 2001

BJU International

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Objective To compare the immunological status of normal and peritumoral bladder walls, and to characterize immunocompetent cells before and during intravesical instillations of bacillus Calmette-Gue Ârin (BCG). Patients and methods Twenty-three patients with super®cial urothelial bladder carcinoma (stages pTa to pT1, grades 1±3) were treated with six weekly instillations of 150 mg of BCG (Pasteur strain). Biopsies of cystoscopically normal bladder wall were taken before, 3 weeks and 3 months after BCG instillation. The controls comprised bladder biopsy specimens from 13 brain-dead ventilated kidney donors. Local in®ltrating cell types, i.e. lymphocyte in®ltrates (CD4, CD8, CD20, CD3, interleukin-2-receptor-positive, natural killer, cd), macrophages and dendritic cells, adhesion and costimulatory molecules (ICAM-1 and B7-BB1) and major histocompatibility complex (MHC) class I and class II antigens were assessed using semiquantitative immunohistochemical analysis.Results Before BCG the peritumoral bladder wall had fewer macrophages than control bladder wall. BCG treatment restored normal numbers of macrophages and enhanced T helper lymphocytes, B lymphocytes, natural killer cells, activated lymphocytes, dendritic cells, normal MHC class I, adhesion (ICAM-1) and costimulatory (B7-BB1) expression. The enhancement of these immunological variables was transient, with a return to baseline 3 months after BCG instillation. Conclusions These results support the concept that there is a host-immune escape associated with bladder cancer. BCG therapy may temporarily restore impaired tumour rejection mechanisms in the peritumoral bladder wall, suggesting a need for maintenance therapy after the ®rst course of BCG.

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“…Intravesical BCG instillation has been demonstrated to be effective especially against CIS of the bladder [1][2][3][4]. In the present case, CIS of the bladder was treated successfully with intravesical BCG instillation therapy, but VUR was found after 3 years.…”

Section: Discussionmentioning

confidence: 55%

“…In the present case, CIS of the bladder was treated successfully with intravesical BCG instillation therapy, but VUR was found after 3 years. Various kinds of complications have been reported in the treatment of superficial bladder cancer by intravesical BCG instillation [1][2][3][4]. However, no case report of intravesical BCG instillation therapy complicated by VUR has been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Vesicoureteral Reflux after Intravesical Instillation of Bacillus Calmette-Guérin against Carcinoma in situ of the Bladder

Morita¹,

Tokue²

2004

Urol Int

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Bacille Calmette‐Guérin in superficial transitional cell carcinoma

Cited by 56 publications

References 107 publications

Clinical outcome of bacillus Calmette‐Guérin perfusion therapy for carcinoma in situ of the upper urinary tract

Clinical outcome of bacillus Calmette‐Guérin perfusion therapy for carcinoma in situ of the upper urinary tract

Evaluation of cellular tumour rejection mechanisms in the peritumoral bladder wall after bacillus Calmette‐Guérin treatment

Vesicoureteral Reflux after Intravesical Instillation of Bacillus Calmette-Guérin against Carcinoma in situ of the Bladder

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