Adjuvant immunotheraphy in the treatment of superficial multicentric bladder tumors

Abstract

The authors report their results in adjuvant immunotherapy with B.C.G. after TUR for superficial and multicentric bladder tumors (Ta-T1). After TURB a cycle of intravesical immunotheraphy with 150 mg of BCG (Bacillus Calmette-Guerin) is performed once a week for 6 weeks, ther every 2 weeks for 6 times and finally once a month for 1 year. (16.5 months of treatment). Controls with CTM and cystoscopy are performed periodically. 63 patients have been treated: 20 (60.6%) are free from disease with follow-up of 18–36 months; 87.5% of patients who had BCG as immunotherapy after first TUR for bladder tumor, are free from disease. Comparing their results with experiences reported in literature with Mytomicin and Doxorubicin, the authors think that adjuvant immunotherapy with BCG is actually the best local treatment for these tumors. Some patients (25%) had slight troubles because of therapy but only in 3 cases (9.09%) treatment was stopped. In conclusion intravesical therapy with BCG significantly changes natural history of superficial bladder tumor, increasing the time free from disease (in our experience: 27 months).