Immunoprophylactic intravesical application of bacillus Calmette-Guerin after transurethral resection of superficial XXXX .

@entity1 @entity150 @entity5 @entity11090
AIM: To evaluate the effect of intravesical instillation of Bacillus Calmette-Guerin (BCG) in the prevention of recurrence and progression of the superficial @entity150 . METHODS: Between February 1989 and May 1994, 170 @entity1 with histologically proven superficial transitional cell @entity150 stage Ta and T1 were assessed as eligible for 6-week + 6-month protocol of intravesical BCG instillation at the Split University Hospital. All @entity1 underwent complete transurethral resection of the @entity5 , which established @entity5 size, histology, stage, and absence of @entity11090 . Out of 170 @entity1 offered to receive intravesical BCG instillations, 80 agreed to undergo the treatment (BCG group), and 90 refused it (control group). The median duration of follow-up was 64 months (range, 16-128). RESULTS: The BCG group had lower incidence rates of recurrence (12 vs 26 events per 100 @entity1 -years in controls, p<0.001) and progression (3.0 vs 6.6 events per 100 @entity1 -years in controls, p=0.017, large-sample one-sample binomial test in both cases) than the control group, but similar mean intervals to first recurrence or progression. The 5-year recurrence-free rates were 55% in BCG @entity1 and 31% in controls, and in case of progression, 86% and 70%, respectively. Cox regression showed that the independent predictors of recurrence were @entity5 size (p<0.001), absence of BCG treatment (p=0.002), and @entity1 age (p=0.05). The single independent predictor of @entity5 progression was absence of BCG treatment, but only in case of @entity5 grade III (roughly doubling the relative risk of the event). CONCLUSION: Our data suggest that BCG intravesical instillation, using 6 week + 6 month scheme, prevents against recurrence and progression of superficial @entity150 . This treatment should be especially advocated in @entity1 with advanced grade @entity5 , but the scheme remains to be evaluated against other BCG treatment schemes.
