Bacillus Calmette-Guerin perfusion therapy for the treatment of transitional cell carcinoma in situ of the upper urinary tract

被引:54
|
作者
Nonomura, N [1 ]
Ono, Y [1 ]
Nozawa, M [1 ]
Fukui, T [1 ]
Harada, Y [1 ]
Nishimura, K [1 ]
Takaha, N [1 ]
Takahara, S [1 ]
Okuyama, A [1 ]
机构
[1] Osaka Univ, Sch Med, Dept Urol, Suita, Osaka 5650871, Japan
关键词
bacillus Calmette-Guerin; carcinoma in situ; upper urinary tract;
D O I
10.1159/000020365
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives: The aim of this study is to evaluate the efficacy a nd safety of intrarenal bacillus Calmette-Guerin (BCG) instillation as a treatment for transitional cell carcinoma in situ (CIS) of the upper urinary tract. Methods: Diagnostic criteria of upper urinary tract CIS were (1) positive urinary cytology, (2) negative multiple random biopsy of the bladder and prostatic urethra, (3) negative radiograph ic findings in the upper urinary tract and (4) two serial positive cytologies in selective ipsilateral urine sampling from the pyeloureteral system. Eleven patients diagnosed as having upper urinary tract CIS were enrolled in this study. Thus, 11 renal units were treated with BCG instillation. After placing a 6-french Double-J stent, BCG (80 mg) in 40 mi saline was instilled into the bladder weekly, 6 times in total as one course. Results: At the end of one course, 9 cases showed negative urinary cytology. Among these 9 cases, 2 showed recurrence in the upper urinary tract after 4 months and 8 months of disease-free interval, respectively. These 2 cases have received an additional course of BCG instillation, but the urinary cytology did not normalize. Mean recurrence-free time was 19.6 months. Of the other 7 cases who responded to the first course of instillation, 6 cases were alive with no evidence of the disease. The remaining patient died of rectal cancer with no evidence of transitional cell carcinoma (TCC). Of the 2 cases who showed positive urinary cytology even after the first course, 1 underwent nephroureterectomy. The other case was diagnosed as having malignant lymphoma 3 months after the end of this instillation therapy, and he died of malignant lymphoma. As side effects, 8 cases (72.7%) showed bladder irritability, and 4 presented fever higher than 38 degreesC. However, no patient needed antitubercular treatment. Conclusion: As for the short-term response, BCG instillation for the treatment of upper urinary tract CIS is considered to be effective and safe. Longer follow-up and further experience with this treatment are required. Copyright (C) 2000 S. Karger AG. Basel.
引用
收藏
页码:701 / 704
页数:4
相关论文
共 50 条
  • [31] Management of primary upper urinary tract carcinoma in situ diagnosed by ureteroscopic biopsy: Is bacillus Calmette-Guerin an alternative to nephroureterectomy?
    Territo, A.
    Fontanet, S.
    Meneghetti, I.
    Gallioli, A.
    Sanguedolce, F.
    Rodriguez-Faba, O.
    Gaya, J. M.
    Palou, J.
    Huguet, J.
    Breda, A.
    ACTAS UROLOGICAS ESPANOLAS, 2023, 47 (04): : 221 - 228
  • [32] Significance of p53 overexpression in urinary bladder transitional cell carcinoma in situ before and after bacillus Calmette-Guerin treatment
    Ick, K
    Schultz, M
    Stout, P
    Fan, K
    UROLOGY, 1997, 49 (04) : 541 - 546
  • [33] BACILLUS CALMETTE-GUERIN FOR SUPERFICIAL TRANSITIONAL CELL-CARCINOMA OF THE BLADDER
    SCHELLHAMMER, PF
    LADAGA, LE
    FILLION, MB
    JOURNAL OF UROLOGY, 1986, 135 (02): : 261 - 264
  • [34] INTRAVESICAL BACILLUS CALMETTE-GUERIN IN THE TREATMENT OF SUPERFICIAL TRANSITIONAL CELL-CARCINOMA OF THE BLADDER
    PANSADORO, V
    DEPAULA, F
    JOURNAL OF UROLOGY, 1987, 138 (02): : 299 - 301
  • [36] Effect of intravesical treatment of transitional cell carcinoma with bacillus Calmette-Guerin and mitomycin C on urinary survivin levels and outcome
    Hausladen, DA
    Wheeler, MA
    Altieri, DC
    Colberg, JW
    Weiss, RM
    JOURNAL OF UROLOGY, 2003, 170 (01): : 230 - 234
  • [37] BACILLUS CALMETTE-GUERIN TREATMENT OF 39 PATIENTS WITH SUPERFICIAL TRANSITIONAL CELL-CARCINOMA OF THE BLADDER
    ALKHALIFA, MA
    ELFVING, P
    MANSSON, W
    COLLEEN, S
    SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY, 1991, 25 (02): : 135 - 139
  • [38] Bacillus Calmette-Guerin: Is monthly maintenance an option for transitional cell carcinoma of the bladder?
    Flanigan, RC
    DeLaurentis, DA
    Waters, WB
    Kunz, K
    UROLOGIC ONCOLOGY, 2001, 6 (01): : 16 - 19
  • [39] Treatment of carcinoma in situ with intravesical bacillus Calmette-Guerin without maintenance
    Griffiths, TRL
    Charlton, M
    Neal, DE
    Powell, PH
    JOURNAL OF UROLOGY, 2002, 167 (06): : 2408 - 2412
  • [40] Clinical impact of Bacillus Calmette-Guerin (BCG) Therapy on prognosis in patients with carcinoma in situ (CIS) of the upper urinary tract: A retrospective comparison with nephroureterectomy.
    Yoneyama, Takahiro
    Soma, Osamu
    Suzuki, Yuuichiro
    Yoneyama, Tohru
    Mori, Kazuyuki
    Yamamoto, Hayato
    Imai, Atsushi
    Hatakeyama, Shingo
    Hashimoto, Yasuhiro
    Ohyama, Chikara
    JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (07)