Johannes A Witjes1. 1. Department of Urology, University Medical Centre St. Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. F.Witjes@uro.umcn.nl
Abstract
OBJECTIVE: Review management of bacillus Calmette-Guérin (BCG) failures in superficial bladder cancer. METHOD: Search of published literature and meeting abstracts. RESULTS: Patients in whom BCG fails are not a uniform group. Failure cannot be predicted but high-risk patients can be identified. In case of failure and progression the outcome is bad. Conservative but investigative alternatives are BCG/interferon-alpha, intravesical hyperthermia/chemotherapy, or photodynamic therapy. Standard treatment in failing patients remains cystoprostatectomy. CONCLUSION: BCG failures need careful and individualized therapy in experienced hands.
OBJECTIVE: Review management of bacillus Calmette-Guérin (BCG) failures in superficial bladder cancer. METHOD: Search of published literature and meeting abstracts. RESULTS:Patients in whom BCG fails are not a uniform group. Failure cannot be predicted but high-risk patients can be identified. In case of failure and progression the outcome is bad. Conservative but investigative alternatives are BCG/interferon-alpha, intravesical hyperthermia/chemotherapy, or photodynamic therapy. Standard treatment in failing patients remains cystoprostatectomy. CONCLUSION:BCG failures need careful and individualized therapy in experienced hands.
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