In situ transitional cell carcinoma involvement of prostatic urethra: Bacillus calmette-guérin therapy without previous transurethral resection of the prostate

Palou, Joan; Xavier, B.; Laguna, Pilar; Montlleó, M.; Vicente, J.

doi:10.1016/s0090-4295(99)80481-6

Cited by 33 publications

(15 citation statements)

References 18 publications

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“…Studies reporting on the results of BCG therapy (with and without TURP) are presented in Table 1[8,9,11–13]. Analysis of the pooled data shows that management with TURP followed by BCG immunotherapy may provide significantly higher prostatic urethra CR rates than immunotherapy alone (95.3% vs 66%, respectively, P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

Prostatic urothelial carcinoma: is transurethral prostatectomy necessary before bacillus Calmette‐Guérin immunotherapy?

et al. 2009

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urinary cytology. Also, the outcome of previous series using similar methodology was compared with the outcome of studies in which TURP was not performed. RESULTSIn all, 20 patients with PUC were treated with TURP followed by intravesical instillations of BCG. The median follow-up was 52.5 months. All patients had an initial complete response (CR). The prostatic urethra 5-year recurrence-free survival rate was 90%. However, bladder and prostatic urethra 5-year recurrence-free survival rate was only 30%. Five patients (25%) died from urothelial carcinoma (UC) after a median period of 58.5 months (two from bladder cancer metastases and three from upper tract metastases). The long-term prostatic urethra CR rate in studies using TURP before immunotherapy was significantly higher than the CR rate in studies using immunotherapy alone ( P < 0.001). However, there was no difference when bladder and prostatic urethra CR rates were considered together ( P = 0.54). CONCLUSIONIn patients with PUC, TURP before BCG immunotherapy eliminates PUC in most cases, and is probably the preferred treatment for this disease. The risk of UCspecific mortality in these patients is high. KEYWORDSprostatic urothelial carcinoma, transurethral prostatectomy, bacillus Calmete-Gúerin immunotherapy Study Type -Therapy (case series) Level of Evidence 4 OBJECTIVETo evaluate the efficacy of transurethral prostatectomy (TURP) followed by bacillus Calmette-Guérin (BCG) immunotherapy in patients with prostatic urothelial carcinoma (PUC) and compare the results of studies using combined TURP and BCG with studies in which TURP was not performed. PATIENTS AND METHODSPatients with bladder cancer and PUC were treated with TURP followed by six weekly intravesical instillations of BCG. Response was determined and monitored by periodic bladder and prostatic urethra biopsies and

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Section: Resultsmentioning

confidence: 99%

Prostatic urothelial carcinoma: is transurethral prostatectomy necessary before bacillus Calmette‐Guérin immunotherapy?

et al. 2009

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“…From these results, early treatment failure after six weekly instillations is an alarming signal which requires immediate re‐assessment of the patient to exclude muscle‐invasive bladder cancer or extravesical CIS, either in the upper urinary tract or in the prostatic urethra. The presence of CIS in the prostatic urethra can be managed with endovesical BCG as an initial treatment, with fairly good success (70–100%) [ 102–104]. There is no need for TUR, even though a loop biopsy may have to be taken at the first control examination to ensure that there is no stromal invasion [ 102].…”

Section: Clinical Resultsmentioning

confidence: 99%

Bacille Calmette‐Guérin in superficial transitional cell carcinoma

Mungan

Witjes

1998

British Journal of Urology

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“…BCG therapy is also effective in patients with CIS of the prostatic urethra and transurethral resection is thought to have no added advantage [60] However, presence of CIS of the prostatic urethra carries a poorer prognosis and in primary high grade bladder cancers treated with BCG, it is recommended that the prostatic urethra is biopsied as it is a prognostic factor for recurrence, progression of disease and bladder cancer specific mortality [61]. Presence of CIS of the prostatic urethra is also an indication for early cystectomy [62].…”

Section: Treatment For Non-intravesical Cis Of the Bladdermentioning

confidence: 99%