LONG-TERM EFFECTS OF BACILLUS CALMETTE-GUERIN PERFUSION THERAPY FOR UPPER URINARY TRACT UROTHELIAL CARCINOMA IN SITU

343 Background: Bacillus Calmette-Guerin (BCG) therapy has already been established as a treatment for muscle noninvasive bladder cancer. Although there are several reports indicating the effectiveness of BCG perfusion therapy for the upper urinary tract urothelial carcinoma in situ(CIS), it is not well established yet. We conducted a retrospective study to assess the long-term effects of BCG perfusion therapy for the upper urinary tract CIS. Methods: Thirty-one subjects (24 male, 7 female) who received BCG perfusion therapy for the upper urinary tract CIS from December 1997 to December 2013 were enrolled. 11 subjects had the entire urinary tract CIS, 8 had bilateral, 12 had unilateral CIS of the urinary tract. The average period of observation was 49.9 months (ranging from 5 to 196 months), and the average subject age was 74.8 years (ranging from 56 to 90 years). We used a double-J catheter for 22 cases, a transvesical single-J catheter whose curl was positions in an upper calyx for 8 cases, and a straight ureteral catheter inserted for ureterocutaneostomy for 1 case. We used 80 mg of BCG for the first five cases, 40 mg for the late 26 cases. Urine cytology was performed to assess the treatment validity. Results: Of the 31 cases, the treatment protocol was completed in 27 cases. Urine cytology tests became negative in 25 of the 31 subjects (80.7%) who underwent upper urinary tract perfusion. Among these 22 subjects who had negative tests, 8 subjects had a recurrence in their upper urinary tracts. Side effects were observed in 28 subjects (90.3%), and the most common side effect was bladder irritation. Localized renal tuberculosis, which was successfully treated with conservative therapy, was seen in two cases. Conclusions: BCG perfusion therapy for the upper urinary tract CIS is effective. However, severe side effects are possible, and careful observation is essential while using this therapy.

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Long-term outcome of bacilles Calmette-Guerin perfusion therapy for upper urinary tract urothelial carcinoma in situ.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.265 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 265-265

Author(s):

Takahiro Yoneyama ◽

Naoki Sugiyama ◽

Yuuichirou Suzuki ◽

Akiko Okamoto ◽

Hayato Yamamoto ◽

...

Keyword(s):

Urinary Tract ◽

Side Effects ◽

Urothelial Carcinoma ◽

Carcinoma In Situ ◽

Upper Urinary Tract ◽

Term Outcome ◽

Long Term Outcome ◽

Urinary Tract Urothelial Carcinoma

265 Background: Bacillus Calmette-Guerin (BCG) therapy has already been established as a treatment for muscle noninvasive bladder cancer. Although there are several reports indicating the effectiveness of BCG perfusion therapy for the upper urinary tract urothelial carcinoma in situ (CIS), it is not well established yet. We conducted a retrospective study to assess the long-term outcome of BCG perfusion therapy for the upper urinary tract CIS. Methods: Twenty-six subjects (20 male, 6 female) who received BCG perfusion therapy for the upper urinary tract CIS from December 1997 to December 2011 were enrolled. Ten subjects had the entire urinary tract CIS, seven had bilateral, nine had unilateral CIS of the urinary tract. The average period of observation was 52.6 months (ranging from 5 to 156 months), and the average subject age was 73.6 years (ranging from 56 to 90 years). We used a double-J catheter for 17 cases, a transvesical single-J catheter whose curl was positions in an upper calyx for eight cases, and a straight ureteral catheter inserted for ureterocutaneostomy for one case. We used 80 mg of BCG for the first five cases, 40 mg for the late twenty-one cases. Urine cytology was performed to assess the treatment validity. Results: Of the 26 cases, the treatment protocol was completed in 21 cases. Urine cytology tests became negative in 22 of the 26 subjects (84.6%) who underwent upper urinary tract perfusion. Among these 22 subjects who had negative tests, five subjects had a recurrence in their upper urinary tracts. Side effects were observed in 25 subjects (96.5%), and the most common side effect was bladder irritation. Localized renal tuberculosis which was successfully treated with conservative therapy was seen in two cases. Conclusions: BCG perfusion therapy for the upper urinary tract CIS is active. However, severe side effects are possible, and careful observation is essential while using this therapy.

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Intrarenal bacillus Calmette-Guérin therapy for carcinoma in situ of the upper urinary tract: long-term follow-up and natural course in cases of failure

BJU International ◽

10.1046/j.1464-410x.2001.02297.x ◽

2001 ◽

Vol 88 (4) ◽

pp. 343-347 ◽

Cited By ~ 46

Author(s):

K. Okubo ◽

K. Ichioka ◽

N. Terada ◽

Y. Matsuta ◽

K. Yoshimura ◽

...

Keyword(s):

Urinary Tract ◽

Carcinoma In Situ ◽

Upper Urinary Tract ◽

Natural Course ◽

Bacillus Calmette Guerin ◽

Long Term Follow Up

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Long-term effects of bacille calmette-guérin perfusion therapy for treatment of transitional cell carcinoma in situ of upper urinary tract

Urology ◽

10.1016/j.urology.2004.01.046 ◽

2004 ◽

Vol 63 (6) ◽

pp. 1084-1088 ◽

Cited By ~ 43

Author(s):

Yasushi Hayashida ◽

Koichiro Nomata ◽

Mitsuru Noguchi ◽

Jiro Eguchi ◽

Sigehiko Koga ◽

...

Keyword(s):

Urinary Tract ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Carcinoma In Situ ◽

Transitional Cell ◽

Upper Urinary Tract ◽

Long Term Effects ◽

Bacille Calmette Guerin

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Long-Term Effects of Bacille Calmette-Guérin Perfusion Therapy for Treatment of Transitional Cell Carcinoma In Situ of Upper Urinary Tract

The Journal of Urology ◽

10.1016/s0022-5347(05)60616-7 ◽

2005 ◽

Vol 173 (5) ◽

pp. 1534-1535

Author(s):

James E. Montie

Keyword(s):

Urinary Tract ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Carcinoma In Situ ◽

Transitional Cell ◽

Upper Urinary Tract ◽

Long Term Effects ◽

Bacille Calmette Guerin

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Long-term outcome of upper urinary tract carcinoma in situ: Effectiveness of nephroureterectomy versus bacillus Calmette-Guérin therapy

International Journal of Urology ◽

10.1111/j.1442-2042.2006.01312.x ◽

2006 ◽

Vol 13 (4) ◽

pp. 340-344 ◽

Cited By ~ 25

Author(s):

YOSHIYUKI KOJIMA ◽

KEIICHI TOZAWA ◽

NORIYASU KAWAI ◽

SHOICHI SASAKI ◽

YUTARO HAYASHI ◽

...

Keyword(s):

Urinary Tract ◽

Carcinoma In Situ ◽

Upper Urinary Tract ◽

Bacillus Calmette Guerin ◽

Term Outcome ◽

Long Term Outcome ◽

Upper Urinary Tract Carcinoma

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Intrarenal bacillus Calmette-Guérin therapy for carcinoma in situ of the upper urinary tract: long-term follow-up and natural course in cases of failure

BJU International ◽

10.1046/j.1464-410x.2002.t01-9-02731.x ◽

2002 ◽

Vol 89 (6) ◽

pp. 640-640 ◽

Cited By ~ 2

Author(s):

M. Kawakami

Keyword(s):

Urinary Tract ◽

Carcinoma In Situ ◽

Upper Urinary Tract ◽

Natural Course ◽

Bacillus Calmette Guerin ◽

Long Term Follow Up

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Long-term effects of Bacilles Calmette-Guerin perfusion therapy for elderly patients with upper urinary tract urothelial carcinoma in situ.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.404 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 404-404

Author(s):

Takahiro Yoneyama ◽

Jotaro Mikami ◽

Naoki Fujita ◽

Tendo Sato ◽

Yuta Kojima ◽

...

Keyword(s):

Urinary Tract ◽

Side Effects ◽

Elderly Patients ◽

Carcinoma In Situ ◽

Upper Urinary Tract ◽

Urine Cytology ◽

Long Term Effects ◽

Bcg Therapy

404 Background: According to several guidelines, the standard therapy for carcinoma in situ (CIS) of the upper urinary tract is total nephroureterectomy. However, it is difficult to determine a treatment strategy for elderly patients. Bacillus Calmette-Guerin (BCG) therapy has already been established as a treatment for non-muscle invasive bladder cancer. However, although there are several reports indicating the effectiveness of BCG perfusion therapy for the upper urinary tract CIS, it has not been established yet. We conducted a retrospective study to assess the long-term effects of BCG perfusion therapy for the upper urinary tract CIS for elderly patients. Methods: We treated 34 patients with upper urinary tract CIS at our clinic between August 2004 and March 2015. 29 patients (22 men and 7 women) with the age of 65 years or older were enrolled. 11 subjects had the entire urinary tract CIS, 8 had bilateral, 10 had unilateral CIS of the upper urinary tract. The average period of observation was 45.5 months ( 5 to 151 ), and the average subject age was 76.5 years (66 to 90 ). We used a double-J catheter for 22 cases, a transvesical single-J catheter whose curl was positions in an upper calyx for 6 cases, and a straight ureteral catheter inserted for ureterocutaneostomy for 1 case. We used 80 mg of BCG for the first 4 cases, 40 mg for the late 25 cases. The BCG treatment was given once a week for consecutive 6 weeks. Urine cytology was performed to assess the treatment validity. Results: Urine cytology tests became negative in 22 of the 29 subjects (75.9%) who underwent upper urinary tract perfusion therapy. Among these 22 subjects who had negative tests, 6 subjects had a recurrence in their upper urinary tracts. Side effects were observed in 28 subjects (89.7%), and the most common side effect was bladder irritation. Localized renal tuberculosis which was successfully treated with conservative therapy was seen in two cases. Conclusions: BCG perfusion therapy for the upper urinary tract CIS is safe and effective for elderly patients. Results also suggested that this could be one of the effective treatment options. However, we have to be careful for severe side effects.

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