Patients treated with two or more courses of BCG for high-risk non-muscle-invasive bladder cancer are at increased risk of second-site primary tumours of the upper urinary tract and prostatic urethra. A new study highlights the importance of looking for urothelial cancer in extravesical disease sites.
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References
Jakse, G. et al. Intravesical BCG in patients with carcinoma in situ of the urinary bladder: long-term results of EORTC GU Group phase II protocol 30861. Eur. Urol. 40, 144–150 (2001).
Lamm, D. L. et al. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J. Urol. 163, 1124–1129 (2000).
Hinotsu, S. et al. Maintenance therapy with bacillus Calmette-Guerin Connaught strain clearly prolongs recurrence-free survival following transurethral resection of bladder tumour for non-muscle-invasive bladder cancer. BJU Int. 108, 187–195 (2011).
Oddens, J. et al. Final results of an EORTC-GU cancers group randomized study of maintenance bacillus Calmette-Guerin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance. Eur. Urol. 63, 462–472 (2013).
Giannarini, G. et al. Bacillus Calmette-Guerin failure in patients with non-muscle-invasive urothelial carcinoma of the bladder may be due to the urologist's failure to detect urothelial carcinoma of the upper urinary tract and urethra. Eur. Urol. http://dx.doi.org/10.1016/j.eururo.2013.09.049.
Herr, H. W. Extravesical tumour relapse in patients with superficial bladder tumours. J. Clin. Oncol. 16, 1099–1102 (1998).
Huguet, J. et al. Cystectomy in patients with high risk superficial bladder tumours who fail intravesical BCG therapy: pre-cystectomy prostate involvement as a prognostic factor. Eur. Urol. 48, 53–59 (2005).
Ray, E. R. et al. Hexylaminolaevulinate fluorescence cystoscopy in patients previously treated with intravesical bacille Calmette-Guerin. BJU Int. 105, 789–794 (2010).
Lerner, S. P. et al. Failure to achieve a complete response to induction BCG therapy is associated with increased risk of disease worsening and death in patients with high risk non-muscle invasive bladder cancer. Urol. Oncol. 27, 155–159 (2009).
Skinner, E. C. et al. SWOG S0353: Phase II trial of intravesical gemcitabine in patients with nonmuscle invasive bladder cancer and recurrence after 2 prior courses of intravesical bacillus Calmette-Guerin. J. Urol. 190, 1200–1204 (2013).
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von Rundstedt, FC., Lerner, S. Always consider extravesical sites when BCG fails. Nat Rev Urol 11, 11–12 (2014). https://doi.org/10.1038/nrurol.2013.302
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DOI: https://doi.org/10.1038/nrurol.2013.302