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- Title
Tratamentul adjuvant intravezical cu BCG Cantacuzino în tumorile vezicale neinvazive cu risc mediu/crescut.
- Authors
Glück, G.; Stoica, R.; Neagoe, L.; Vesa, N.
- Abstract
Purpose: To assess the role of association of 1 single-shot instillation with Epirubicin and intravesical BCG post-transurethral resection for prevention of recurrence and progression of the medium/high risk, non-invasive bladder tumours. Patients and methods: Between 2002-2005, 136 patients with non-invasive bladder tumours were treated by the same surgeon (Dr. G. Glück). Between 2000-2002, I have had 71 patients with only TUR. In this group, retrospectively, we found 40 patients with intermediate risk tumours and 31 with high risk non-invasive bladder tumours (group A). Stratification according the stage were: 36 pTa, 35 pT1. Stratification according the grading were: 42 G1, 25 G2, 4 G3. 16 were female and 55 male patients. Mean age were 67 years (ranged between 41-84 years). The mean follow-up was 86 months (ranged between 76-108). The second group consisted of 55 patients which received, between August 2002 - April 2005, the treatment according to 2002 EAU protocol. 10 patients belongs to intermediate risk group, 45 to high risk bladder tumors:10 Ta, 45 T1. Stratifications according the grading were: 23 G1, 28 G2, 4 G3. 13 were female and 42 male patients. The mean age in this group was 60,3 years (ranged between 16-81 years). The mean follow-up was 62 months (range between 44-80 months). The criterias for administration of BCG were the following: multiple tumors at the first presentation, tumour size more than 3 cm, associated Cis, high grade, early recurrency, high rate of reccurency. All the patients received one instilation with 50 mg of Farmarubicin in the first 6 hours post TUR-BT. The BCG therapy (I used Romanian BCG) began at 14 days post TUR-BT. I used 150 mg BCG/instilation, each patient received 6 instillations. If a patient developed reccurence, I resect the tumour then he received another cycle of 6 instilations. In selected cases (15 patients) I used the maintenance therapy. In 11 cases I performed re-TURB-BT. Results: In the group A 33 patients (46,4%) developed recurrencies (36 recurrencies ). 14 patients (19,7%) developed tumor progression. Deaths: 28 (11 oncological). In group B, 16 patients (29%) have had 29 recurrencies. 7 patients developed tumor progression: 9 patients (16,3%) developed complications (cystitis, arthritis, vasculitis, gonarthritis). In this group of patients we have 16 deaths (7 oncological one). Conclusions: We confirmed that intravesical Cantacuzino BCG seems to be an efficient tool for the adjuvant treatment of superficial bladder tumours. The recurrence rate is reduced with 17,4%; the progression rate is reduced with 7%.
- Subjects
BCG vaccines; BLADDER cancer treatment; ADJUVANT treatment of cancer; DISEASE progression; CANCER relapse; NONINVASIVE diagnostic tests; CANCER invasiveness; QUANTITATIVE research; RESEARCH methodology
- Publication
Romanian Journal of Urology, 2009, Vol 8, Issue 4, p36
- ISSN
1223-0650
- Publication type
Article