1987 Volume 78 Issue 10 Pages 1769-1775
Twenty-nine patients suffering from superficial bladder tumor were treated with intravesical BCG as prophylaxis against tumor recurrence. The patients were divided into two groups, which were a group of primary cases and a group of recurrent cases. BCG therapy was initiated on the second week after transurethral resection of tumors. 80mg of BCG in 40ml physiologic saline was instilled into the bladder weekly for 6 weeks. A post-operative follow-up study for the tumor recurrence was performed by means of urinary cytology every 1 to 3 months and by cystoscopy every 3 months after the operation. In 19 primary cases, 18 remained free of disease during the follow-up term (2-21M). However, one patient relapsed in the thirteenth month after the operation. A significant decrease of the recurrence rate was noted in the BCG treatment group as compared with a historical control group of our institution. In 10 recurrent cases, a distinct reduction of their tumor recurrences by the BCG therapy was documented. Only one patient relapsed in the third month after the operation.
Furthermore, two patients suffering from carcinoma in situ were treated with intravesical BCG therapy successfully. In both cases, their classes of urinary cytology changed to negative in the first month after the BCG therapy. In one of them, CIS region in the bladder transformed to dysplasia histologically in third month after the instillation.
Concerning immunological parameters, PPD skin test and lymphocyte reaction to PHA were studied before and after the therapy. In PPD skin test, 8 of 9 patients with negative finding before the therapy turned into positive after the therapy. Lymphocyte reaction to PHA did not show any considerable changes by the therapy.
Although there were some unwanted side effects such as bladder irritability, hematuria, urinary tract infection and low grade fever during or after the therapy, they were minor and self-limiting in the large majority of the patients except two patients. Two patients were obliged to interrupt the therapy due to a severe bladder irritability or a progression of granulomatous prostatitis.
