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

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.

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

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 343-343
Author(s):  
Takahiro Yoneyama ◽  
Yuki Tobisawa ◽  
Tohru Yoneyama ◽  
Hayato Yamamoto ◽  
Atsushi Imai ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Urothelial Carcinoma ◽  
Carcinoma In Situ ◽  
Upper Urinary Tract ◽  
Urine Cytology ◽  
Long Term Effects ◽  
Urinary Tract Urothelial Carcinoma

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.

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

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.

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

Urology ◽  
2004 ◽  
Vol 63 (6) ◽  
pp. 1084-1088 ◽  
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

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

2008 ◽  
Vol 179 (4S) ◽  
pp. 120-120
Author(s):  
Takahiro Yoneyama ◽  
Hayato Yamamoto ◽  
Akiko Okamoto ◽  
Atsushi Imai ◽  
Ikuya Iwabuchi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Carcinoma In Situ ◽  
Upper Urinary Tract ◽  
Bacillus Calmette Guerin ◽  
Long Term Effects ◽  
Urinary Tract Urothelial Carcinoma

Biological Behavior and Long-Term Outcomes of Carcinoma In Situ in Upper Urinary Tract Managed by Radical Nephroureterectomy

2018 ◽  
Vol 199 (4) ◽  
pp. 933-939 ◽  
Author(s):  
Teruo Inamoto ◽  
Hideyasu Matsuyama ◽  
Naokazu Ibuki ◽  
Kazumasa Komura ◽  
Kiyoshi Takahara ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Carcinoma In Situ ◽  
Upper Urinary Tract ◽  
Biological Behavior ◽  
Radical Nephroureterectomy ◽  
Long Term Outcomes

Clinical impact of Bacillus Calmette-Guérin (BCG) Therapy on prognosis in patients with carcinoma in situ (CIS) of the upper urinary tract: A retrospective comparison with nephroureterectomy.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 417-417
Author(s):  
Takahiro Yoneyama ◽  
Osamu Soma ◽  
Yuuichiro Suzuki ◽  
Tohru Yoneyama ◽  
Kazuyuki Mori ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Adverse Events ◽  
Carcinoma In Situ ◽  
Upper Urinary Tract ◽  
Bacillus Calmette Guerin ◽  
Radical Nephroureterectomy ◽  
Bcg Therapy ◽  
The Impact ◽  
Upper Urinary Tract Carcinoma

417 Background: Clinical benefit of bacillus Calmette-Guérin (BCG) therapy for the management of upper urinary tract carcinoma in situ (CIS) remain unclear. We investigated safety and long-term oncological outcome of BCG therapy for upper urinary tract CIS compared with nephroureterectomy. Methods: We treated consecutive 490 patients with upper urinary tract carcinoma Aomori, Japan. We retrospectively reviewed the post-treatment course of 60 patients with CIS of the upper urinary tract who had undergone either a radical nephroureterectomy (RNU group) or BCG therapy (BCG group). Clinical effectiveness, safety, and oncological outcomes were compared between the groups. Multivariate Cox regression analysis via inverse propensity treatment weighted (IPTW) methods was performed to identify the impact of BCG therapy on prognosis. Results: The number of patients in RNU and BCG groups were 22 and 38, respectively. Median follow-up was 59 months in this cohort. There was no significant difference in background of patients including age, sex, performance status between the groups. The reason of selection for BCG therapy were bilateral CIS of upper urinary tract (50%), solitary kidney (26%), and others (24%). The cytology became negative in 30 (79%) patients after 6-week course of BCG. BGC related adverse events were observed 92% of patients. Most common events were cystitis (76%) followed by fever (50%). Two patients experienced grade 3 sepsis after BCG therapy. 13 patients (43%) experienced tumor recurrence after BCG therapy. There were no significant differences in recurrence-free survival, cancer-specific survival, and overall survival between the RNU and BCG groups. Multivariate analysis revealed BCG therapy did not worse the prognosis of those patients. Conclusions: Although mild adverse events were frequented in BCG therapy for CIS of the upper urinary tract, it might be a useful alterative in patients with CIS of the upper urinary tract who are ineligible for radical nephroureterectomy. Further prospective studies are needed to confirm the benefits of BCG therapy for CIS of the upper urinary tract.

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