Monitoring Intravesical Bacillus Calmette-guerin Treatment of Bladder Carcinoma with Flow Cytometry

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Abstract
Flow cytometry of bladder irrigation specimens was studied in 22 patients with low stage bladder carcinoma who were treated by transurethral resection of visible tumor followed in 3-5 wk by a course of intravesical BCG. The most informative examinations were just before the 1st BCG treatment, 6 wk after completing a 6-wk course of treatment (3 mo.) and at 9 mo. Of the patients 10 had recurrent tumors after therapy; recurrence was anticipated correctly by flow cytometry at the 12-wk follow-up examination in 6 of the 10 patients and suspected in another. Of 12 patients who remained clinically free of disease for a minimum of 15 mo. after BCG therapy flow cytometry identified correctly 7 at 12 wk, while 1 had a partial response and the remaining 4 reverted to a negative status at 9 mo. Of interest, only 4 of the 22 patients were free of disease by flow cytometry at the start of BCG treatment despite attempted ablation of the tumor by transurethral resection; this suggests that intravesical administration of BCG destroys existing carcinoma in situ in some cases.