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Intravesical Bacillus Calmette-Guérin in Ta and T1 bladder cancerShelley M, Court JB, Kynaston H, Wilt T, Fish R, Mason M
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SummaryLocal treatment with Bacillus Calmette-Guérin following surgery for superficial bladder cancer reduces the risk of the cancer returning.Worldwide, bladder cancer is common in both men and women. In most cases, the cancer occurs in the superficial layers of the bladder and can be surgically removed. However, in many people the cancer returns. Drugs placed directly into the bladder tissue following surgery are therefore often used to try to prevent the cancer recurring. Bacillus Calmette-Guérin (BCG), a bacterium responsible for tuberculosis, can be used in the bladder to try to prevent the cancer returning. The review found that BCG treatment was effective in preventing cancer recurrence following surgery. Further studies into making treatment more effective are needed.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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October 23. 2000 AbstractBackgroundIntravesical therapy with Bacillus Calmette-Guérin (BCG) aims to reduce the incidence of tumour recurrence following transurethral resection (TUR) for patients with superficial bladder cancer. ObjectivesThe objective of this review was to compare the incidence of tumour recurrence after the standard therapy of transurethral resection versus transurethral resection plus intravesical Bacillus Calmette-Guérin. Search strategyWe searched the Cochrane Controlled Trials Register (March 2000), Medline (February, 2000), EMBASE (February, 2000), Cancerlit (February, 2000), Healthstar (February, 2000), Database of Abstracts of Reviews of Effectiveness (February, 2000) and the Bath Information Data Service. The Proceedings of the American Society Clinical Oncology was hand searched (1996 to 1999). Selection criteriaRandomised or quasi-randomised trials of transurethral resection alone versus transurethral resection plus intravesical Bacillus Calmette-Guérin. Patients with Ta and T1 bladder cancer of medium or high risk of tumour recurrence, were eligible for inclusion. Data collection and analysisFour reviewers assessed trial quality and two abstracted the data independently. The Peto odds ratios and log hazard ratios were determined to compare the number of patients with disease recurrence at 12 months and the rate of recurrence, respectively. Main resultsSix randomised trials were included involving 585 eligible patients. There were significantly fewer patients with disease recurrence at 12 months in the BCG plus TUR group compared to those that received TUR alone (odds ratio 0.30, CI 0.21 to 0.43). The overall log hazard ratio for recurrence (-0.83, variance 0.02) indicated a significant benefit of BCG treatment in reducing tumour recurrence. Toxicities associated with BCG consisted mainly of cystitis (67%), haematuria (23%), fever (25%) and urinary frequency (71%). No BCG-induced deaths were reported. Authors' conclusionsIn patients with medium/high risk Ta or T1 bladder cancer, immunotherapy with intravesical BCG following TUR appears to provide a significant advantage over TUR alone in delaying tumour recurrence. |