Intravesical bacillus Calmette-Guerin in the treatment of superficial transitional cell carcinoma of the bladder.

Pasteur strain bacillus Calmette-Guerin was used to treat 145 patients with superficial transitional cell carcinoma of the bladder: 47 had established residual disease (therapeutic group) and 130 received prophylactic/adjuvant therapy (including 32 who had a complete response in the therapeutic group and then were placed into the prophylactic group). Among the patients in the therapeutic group a complete response rate of 68 per cent (32 of 47 patients, 95 per cent confidence limits 55 to 81 per cent) was achieved. Of those in the prophylactic/adjuvant group 85 per cent (111 of 130 patients, 95 per cent confidence limits 73 to 91 per cent) remain free of disease. The median followup for the therapeutic group was 17 months (range 3 to 49 months). In the prophylactic/adjuvant therapy group the followup was greater than 3 years in 7 per cent, 2 to 3 years in 23 per cent, 1 to 2 years in 29 per cent and up to 1 year in 41 per cent (median 18 months). Our study confirms that Pasteur strain bacillus Calmette-Guerin is safe and efficacious in the treatment and prevention of recurrent superficial bladder carcinoma.