Bladder Tumors Invading the Lamina propria (Stage A/Tl): Influence of Endovesical Bacillus Calmette-Guérin Therapy on Recurrence and Progression

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Abstract
47 patients with transitional cell bladder carcinoma invading the lamina propria (stage A/Ti) were treated from 1984 to 1986 by complete transurethral resection followed by 1-3 cycles of endovesical bacillus Calmette- Guérin instillations, and followed 14-64 months by cytology, endoscopy and bladder biopsies. 64% achieved a complete response. 36% recurred (recurrence rate/100 months/patient 2.2), 21% progressed to muscle invasion. Duration of treatment, tumor size or type (solid vs. papillary), presence of carcinoma in situ bore no relation to the final result. The preceding history of T[ bladder tumor appeared associated with a higher risk of progression although not reaching statistical significance. The results were compared to those obtained by transurethral resection in a similar group of 50 patients treated from 1982 to 1984 and followed up 12-100 months. 90% recurred and 34% progressed to muscle invasion with a recurrence rate/100 months/patient of 9.22. Keeping in mind the limits of a nonrandomized historical comparison, it appears that endovesical bacillus Calmette-Guérin therapy alters favorably the recurrence pattern of T i bladder cancer.