Intravesical Bacillus Calmette-Guérin (BCG) Instillation for Primary and Recurring T1G3 Bladder Cancers

Instruction: With T1G3 bladder cancer, it remains unresolved whether the best treatment option is bladder preservation or total cystectomy. To assess the feasibility of the first option, we performed a clinical evaluation of the efficacy of intravesical instillation of bacillus Calmette-Guérin (BCG) for prevention of T1G3 bladder cancer recurrence after transurethral resection of bladder tumor (TUR-Bt).
Methods: A total of 30 patients with T1G3 bladder cancers received 6 to 8 weekly instillations of BCG followed in some cases by further applications at monthly intervals.
Results: Recurrence occurred in 13 cases. There were 6 patients with progression, total cystectomy being performed for 5 of these. Further BCG-including treatments were performed in 7 patients, and all of them were alive at the end of the follow-up period. Finally, bladder preservation proved successful in 24 of 30 cases.
Conclusion: Intravesical instillation of BCG in high-risk T1G3 cases, including additional BCG treatment, proved effective and satisfactory in our series. Therefore, this option warrants emphasis with regard to its relative merit compared to total cystectomy.