Bacillus Calmette-Guerin in the treatment of stage T1 grade 3 transitional cell carcinoma of the bladder: long-term results.

Abstract

We performed a retrospective long-term study to evaluate the results of immunotherapy in the treatment of high grade superficial bladder tumors. Between 1981 and 1993, 593 patients with superficial transitional cell carcinoma of the bladder underwent transurethral resection. Of 64 patients with stage T1 grade 3 disease 50 received intravesical bacillus Calmette-Guerin after transurethral resection of all visible tumor. At a median followup of 42 months (range 12 to 112) 36 patients (72%) are disease-free and have not required further treatment. Superficial recurrence was noted in 8 patients (16%). Disease progressed in 6 patients (12%), including 5 with locally invasive and 1 with metastatic disease. Cystectomy was performed for progression in 4 patients and for recurrent stage T1 grade 3 disease in 1. There was 1 disease related death (2%). The overall survival rate is 94%. Intravesical bacillus Calmette-Guerin appears to be the most effective conservative treatment for patients with stage T1 grade 3 bladder cancer.