Superficial Transitional Cell Carcinoma of the Bladder Associated with Mucosal Involvement of the Prostatic Urethra: Results of Treatment with Intravesical Bacillus Calmette-Guerin

Abstract

Intravesical Pasteur strain bacillus Calmette-Guerin was used to treat 8 patients with mucosal transitional cell carcinoma of the prostatic urethra associated with superficial transitional cell carcinoma of the bladder. Complete initial response in the prostatic urethra was obtained in 7 of the 8 patients. Two patients had progression of disease during intravesical bacillus Calmette-Guerin therapy (1 in the prostate and 1 in the bladder) and they received further surgical therapy. Of the 6 complete responders 1 patient had invasive ureteral, vesical and prostatic tumor 15 months after bacillus Calmette-Guerin therapy, and he underwent nephroureterectomy and cystoprostatourethrectomy. Two patients required additional transurethral therapy for recurrent superficial tumors in the bladder but they have shown no evidence of recurrence in the prostatic urethra. Three patients have remained free of disease at 8 to 36 months. Before radical cystoprostatourethrectomy and urinary diversion are recommended, our study supports a course of bacillus Calmette-Guerin therapy as initial treatment for patients with superficial transitional cell carcinoma of the bladder associated with mucosal involvement of the prostatic urethra.

Treatment of bladder cancer in cardiac transplant patients

“…Although prostatic involvement with transitional cell carcinoma carries an ominous prognosis, tumors confined to the ducts and acini without stromal invasion behave as a distinct entity from clinical stage T4 disease [4]. Despite the increased risk for recurrence and progression, previous reports substantiate an initial trial of intra-vesical therapy in this subset of patients [5]. Having progressed on mitomycin therapy and having an absolute contraindication to BCG therapy, radical extirpation offered our patient the greatest chance for cure.…”

Recurrence of Superficial Bladder Tumors in Prostatic Urethra

“…As evaluated by Hardeman et al [4], the fre quency is 16%, but in our study it was 13.3%. Recur rence appeared in patients previously treated with endovesical chemotherapy and immunotherapy [4,7,9], and in some cases after positive response to the treat ment of vesical TIS [1,6]. Therefore, the prostatic ure thra is an area which should be controlled carefully in patients with superficial bladder tumors, particularly those of the multifocal type and those associated with TIS.…”

¿La vacuna BCG puede evitar el cáncer de vejiga?

“…Es en estos pacientes donde el tratamiento del BCG está indicado, ya que mejoran o se curan con su administración 2 . Estudios a largo plazo con terapia de BCG han reportado respuestas favorables 3,4 .…”