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T1G3 transitional cell carcinoma of the bladder: recurrence, progression and survival
Author(s) -
Peyromaure M.,
Zerbib M.
Publication year - 2004
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2004.04556.x
Subject(s) - medicine , cystectomy , bladder cancer , transitional cell carcinoma , urology , carcinoma in situ , surgery , survival rate , mitomycin c , carcinoma , cancer
OBJECTIVES To report our experience with T1G3 bladder tumours over the last 10 years. PATIENTS AND METHODS We analysed the outcome of 74 consecutive patients treated for a T1G3 bladder cancer between 1991 and 2001. Fifty‐seven patients (77%) were treated with transurethral resection (TUR) plus six weekly instillations of bacillus Calmette‐Guérin (BCG) therapy. Ten patients (13.5%) with contraindications to BCG or with a small T1a tumour were treated with TUR plus mitomycin‐C, and seven (9.5%) were treated with TUR alone because of their age. Patients treated with BCG had systematic biopsies taken at the end of the first course. Patients with residual tumour received a second course of six weekly instillations. Patients with negative biopsies received maintenance BCG therapy consisting of intravesical instillations each week for 3 weeks given 3, 6, 12, 18, 24, 30 and 36 months after the first course. RESULTS The median follow‐up was 53 months. The overall recurrence rate was 46% and the overall progression rate 19%. The rate of delayed cystectomy was 8% and that of disease‐specific survival 91%. In patients who received BCG therapy, the recurrence and progression rates were 42% and 23%, respectively. In this group the rate of disease‐specific survival was 88%. CONCLUSION This study confirms that maintenance BCG therapy is an effective treatment for T1G3 bladder tumours, with an acceptable rate of bladder preservation.