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Long‐term outcome of upper urinary tract carcinoma in situ : Effectiveness of nephroureterectomy versus bacillus Calmette‐Guérin therapy
Author(s) -
KOJIMA YOSHIYUKI,
TOZAWA KEIICHI,
KAWAI NORIYASU,
SASAKI SHOICHI,
HAYASHI YUTARO,
KOHRI KENJIRO
Publication year - 2006
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2006.01312.x
Subject(s) - medicine , urology , upper urinary tract , carcinoma in situ , urinary system , bacillus (shape) , carcinoma , oncology , microbiology and biotechnology , biology
Background: We examined the long‐term outcome and compared the usefulness of nephroureterectomy with that of bacillus Calmette‐Guérin (BCG) therapy for the management of upper urinary tract carcinoma in situ (CIS). Methods: We retrospectively reviewed the post‐treatment course of 17 patients with CIS of the upper urinary tract who had undergone either a nephroureterectomy (group A, n = 6) or BCG therapy (group B, n = 11) at our institute. Results: Median follow up was 58.3 months (range 1–120 months). Four of the six patients in group A (67%) had no recurrence and remained cystoscopically, cytologically and radiographically free of disease. The cytology became negative after an 8‐week course in nine of the eleven patients in group B (82%; eight of ten units, 77%). Two of the nine patients showed recurrence after BCG therapy. One patient died of respiratory failure caused by a side‐effect of BCG, which was interstitial pneumonia. There was no significant difference in either the 5‐year recurrence‐free survival or the 5‐year cancer‐specific survival between groups A and B. Conclusions: BCG therapy for CIS of the upper urinary tract is as effective as nephroureterectomy in long‐term outcome, although it has some dangerous aspects. Further experience with treatment of CIS of the upper urinary tract is required.