Initial Experiences of Intravesical Gemcitabine Instillation Followed by Bacillus Calmette-Guerin (BCG) Therapy for Treating Intermediate or High Risk Patients with Superficial Bladder Cancer

2008 ◽  
Vol 49 (4) ◽  
pp. 313 ◽  
Author(s):  
Jong Wook Kim ◽  
Dae Yeon Cho ◽  
Jeong Kyun Yeo ◽  
Hong Seok Park ◽  
Duck Ki Yoon
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Superficial Bladder Cancer ◽  
Bacillus Calmette Guerin ◽  
High Risk Patients ◽  
Bcg Therapy ◽  
Risk Patients

Bacillus Calmette-Guérin therapy alters the progression of superficial bladder cancer.

1988 ◽  
Vol 6 (9) ◽  
pp. 1450-1455 ◽  
Author(s):  
H W Herr ◽  
V P Laudone ◽  
R A Badalament ◽  
H F Oettgen ◽  
P C Sogani ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Disease Progression ◽  
Superficial Bladder Cancer ◽  
Bladder Preservation ◽  
High Risk Patients ◽  
Bcg Therapy ◽  
Risk Patients ◽  
Muscle Invasive

The effectiveness of BCG in preventing disease progression in patients with superficial bladder cancer is evaluated. Long-term follow-up of high-risk patients treated in a previously reported randomized control trial of intravesical plus percutaneous BCG shows that progression occurred in 41/43 (95%) of control and 23/43 (53%) of BCG-treated patients. Muscle invasive and/or metastatic disease occurred with equal frequency in the two groups, but was significantly delayed by BCG treatment (P = .012). Cystectomies were required in 18/43 (42%) control and 11/43 (26%) BCG-treated patients. Median time to cystectomy was 8 months for control v 24 months for BCG-treated patients. Based on initial treatment, survival was improved by BCG therapy (P = .032) (median follow-up 6 years). These results suggest that in high-risk patients intravesical BCG can delay disease progression, prolong the period of bladder preservation, and increase overall survival.

scholarly journals Radical cystectomy for high risk patients with superficial bladder cancer in the era of orthotopic urinary reconstruction

Cancer ◽  
1995 ◽  
Vol 76 (5) ◽  
pp. 833-839 ◽  
Author(s):  
John A. Freeman ◽  
David Esrig ◽  
John P. Stein ◽  
Anne R. Simoneau ◽  
Eila C. Skinner ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Radical Cystectomy ◽  
Superficial Bladder Cancer ◽  
High Risk Patients ◽  
Risk Patients ◽  
Urinary Reconstruction

scholarly journals Management of hepatic granulomatous tuberculosis complicating intravesical BCG for superficial bladder cancer

2012 ◽  
Vol 1 (3) ◽  
Author(s):  
Vincent Fradet ◽  
Christiane Gaudreau ◽  
Paul Perrotte ◽  
Jean Côté ◽  
Jean-Marie Paquin
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Mycobacterium Bovis ◽  
Superficial Bladder Cancer ◽  
Granulomatous Hepatitis ◽  
Bacille Calmette Guerin ◽  
Systemic Complications ◽  
Bcg Therapy ◽  
Intravesical Bcg ◽  
Management Alternatives

Intravesical bacille Calmette-Guérin (BCG) therapy is the most effective treatmentfor high-risk superficial bladder cancer. Severe systemic complications are rare, but may occur in approximately 1% of cases. We report a severe complicationof intravesical BCG: a disseminated Mycobacterium bovis infectionwith biopsy-proven granulomatous hepatitis in a patient with bladder cancer. We also elaborate on the different management alternatives.

scholarly journals Re-operation within 30 days of radical cystectomy: Identifying high-risk patients and complications using ACS-NSQIP database

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rashid K. Sayyid ◽  
Diana Magee ◽  
Amanda E. Hird ◽  
Benjamin T. Harper ◽  
Eric Webb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
African American ◽  
High Risk ◽  
Radical Cystectomy ◽  
High Risk Patients ◽  
Metastatic Bladder Cancer ◽  
Risk Patients ◽  
History Of ◽  
African American Race

Introduction: Radical cystectomy (RC) is a highly morbid procedure, with 30-day complication rates approaching 31%. Our objective was to determine risk factors for re-operation within 30 days following a RC for non-metastatic bladder cancer. Methods: We included all patients who underwent a RC for non-metastatic bladder cancer using The American College of Surgeons National Surgical Quality Improvement Program database between January 1, 2007 and December 31, 2014. Logistic regression analyses were used to evaluate predictors of re-operation. Results: A total of 2608 patients were included; 5.8% of patients underwent re-operation within 30 days. On multivariable analysis, increasing body mass index (BMI) (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01–1.07), African-American race (vs. Caucasian OR 2.29; 95% CI 1.21–4.34), and history of chronic obstructive pulmonary disease (COPD) (OR 2.33; 95% CI 1.45–3.74) were significant predictors of re-operation within 30 days of RC. Urinary diversion type (ileal conduit vs. continent) and history of chemotherapy or radiotherapy within 30 days prior to RC were not. Patients who underwent re-operation within this timeframe had a significantly higher mortality rate (4.0% vs. 1.6%) and were more likely to experience cardiac (7.2% vs. 1.9%), pulmonary (23.0% vs. 3.0%), neurological (2.0% vs. 0.49%), and venous thromboembolic events (10.5% vs. 5.4%), as well as infectious complications (64.5% vs. 24.1%) with a significantly longer hospital length of stay (16.5 vs. 7.0 days). Conclusions: Recognizing increasing BMI, COPD, and African-American race as risk factors for re-operation within 30 days of RC will allow urologists to preoperatively identify such high-risk patients and prompt them to adopt more aggressive approaches to minimize postoperative surgical complications.

The Management of Newly-Diagnosed Non-muscle Invasive Bladder Cancer in Veterans Integrated Services Network 02 of the Veterans Health Administration

2019 ◽  
Author(s):  
Joseph M Caputo ◽  
George Moran ◽  
Benjamin Muller ◽  
Alison T Keller ◽  
Gen Li ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Newly Diagnosed ◽  
Health Administration ◽  
Muscle Invasive Bladder Cancer ◽  
High Risk Patients ◽  
Risk Patients ◽  
Muscle Invasive

Abstract Introduction Over 1,500 bladder cancers were diagnosed among US Veterans in 2010, the majority of which were non-muscle invasive bladder cancer (NMIBC). Little is known about NMIBC treatment within the Veterans Health Administration. The objective of the study was to assess the quality of care for Veterans with newly-diagnosed NMIBC within Veterans Integrated Service Network (VISN) 02. Materials and Methods We used ICD-9 and ICD-10 codes to identify patients with newly-diagnosed bladder cancer from 1/2016–8/2017. We risk-stratified the patients into low, intermediate, and high-risk based on the 2016 American Urological Association Guidelines on NMIBC. Our primary objectives were percentages of transurethral resection of bladder tumors (TURBTs) with detrusor, repeat TURBT in high-risk and T1 disease, high-risk NMIBC treated with induction intravesical therapy (IVT), and responders treated with maintenance IVT. We performed logistic regression for association between distance to diagnosing hospital and receipt of induction IVT in high-risk patients. Results There were 121 newly-diagnosed NMIBC patients; 16% low-risk, 28% intermediate-risk, and 56% high-risk. Detrusor was present in 80% of all initial TURBTs and 84% of high-risk patients. Repeat TURBT was performed in 56% of high-risk NMIBC and 60% of T1. Induction IVT was given to 66% of high-risk patients and maintenance IVT was given to 59% of responders. On multivariate logistic regression, distance to medical center was not associated with receipt of induction IVT (OR = 0.99, 95% CI [0.97,1.01], p = 0.52). Conclusions We observed high rates of sampling of detrusor in the first TURBT specimen, utilization of repeat TURBT, and administration of induction and maintenance intravesical BCG for high-risk patients among a regional cohort of US Veterans with NMIBC. While not a comparative study, our findings suggest high quality NMIBC care in VA VISN 02.

Bacillus Calmette-Guerin Therapy for High Risk Stage T1 Superficial Bladder Cancer

1992 ◽  
Vol 147 (2) ◽  
pp. 376-379 ◽  
Author(s):  
Gregg R. Eure ◽  
Maria R. Cundiff ◽  
Paul F. Schellhammer
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Superficial Bladder Cancer ◽  
Bacillus Calmette Guerin ◽  
Stage T1
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