Conservative treatment of superficial transitional cell carcinoma of prostatic urethra with intravesical BCG Journal Article


Authors: Orihuela, E.; Herr, H. W.; Whitmore, W. F. Jr
Article Title: Conservative treatment of superficial transitional cell carcinoma of prostatic urethra with intravesical BCG
Abstract: We reviewed 125 male patients treated with a six-week course of intravesical bacillus Calmette-Guerin (BCG) for superficial transitional cell cancer (TCC) of the bladder that was associated with mucosal involvement of the prostatic urethra in 15 cases. In 13 of these 15 cases, there was a sustained complete response in both the bladder and the prostate. Among the other 110 patients, in 14 TCC developed in the prostate from one to fifty-three (mean 15) months after completion of BCG. Six of these 14 had had complete response in the bladder. Recurrent TCC in the prostate was .seen in only 4 percent and 6 percent of patients who had prostatic urethritis on cystos-copy and prostatic granulomas on biopsy, respectively. In contrast, recurrence was observed in 14 percent of those without urethritis and in 44 percent of those without granulomas. Transurethral resection of the prostate (TURP) prior to BCG did not appear to influence tumor recurrence in the prostate. However, after BCG, 3 patients with recurrent TCC in the prostate had complete local response after TURP alone. Further, prostatic urethritis (73%) and prostatic granulomas (60%) were more frequent among patients who had TURP prior to BCG than in those without TURP (33 % and 27 %, respectively). Superficial TCC of the bladder associated with mucosal involvement of the prostatic urethra can be treated successfully with intravesical BCG. In addition, our results suggest that intravesical BCG has a prophylactic effect on tumor recurrence in the prostate, and that TURP may have an important role bit removing present disease and by facilitating the development of an effective biologic response to BCG in the prostate. TCC in the prostate is a significant cause of relapse, and frequent surveillance of the prostatic urethra should be performed in conservatively treated patients with superficial bladder cancer. © 1989.
Keywords: adult; aged; aged, 80 and over; major clinical study; bcg vaccine; neoplasm recurrence, local; prostate; prostatectomy; tumor recurrence; bladder neoplasms; transurethral resection; carcinoma, transitional cell; administration, intravesical; bladder carcinoma; transitional cell carcinoma; granuloma; middle age; urethral neoplasms; topical drug administration; urethritis; superficial cancer; human; male; priority journal; urethra prostatic part
Journal Title: Urology
Volume: 34
Issue: 5
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 1989-11-01
Start Page: 231
End Page: 237
Language: English
DOI: 10.1016/0090-4295(89)90314-2
PUBMED: 2815442
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 14 April 2020 -- Source: Scopus
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  1. Harry W Herr
    594 Herr
  2. Willet F. Whitmore Jr
    139 Whitmore