A single institution's 10 year experience of treating high grade superficial transitional cell carcinoma and carcinoma in situ of the bladder with intravesical BCG

Objective: The authors of this paper review the outcomes of patients at their institution who received intravesical Bacille Calmette-Guerin (BCG) for either high grade superficial TCC or CIS of the bladder over a 10-year period. Patients and methods: Seventy one patients received intravesical BCG over a 10-year period. Fortyone had primary CIS, 21 had G3 T1 disease and 6 had G3 Ta disease prior to commencement of BCG. The medical records of these patients were reviewed and the following details were recorded: time of diagnosis; time of commencement of BCG; result of the first check cystoscopy; time to first recurrence, if a recurrence occurred; time to disease progression, if this occurred; and cause of death if appropriate. Results: After a median follow up time of 22.5 months (range 6-114 months), 81% of the patients responded initially to BCG. During follow up 31% had a recurrence and 25% underwent disease progression. The mortality rate of the group as a whole from TCC was 16%. Conclusions: The authors feel that these results, which compare favourably with those previously reported, support the practice of using intravesical BCG in these high risk groups of patients, although these patients should be rigorously followed up and radical treatment should be considered should BCG "fail".