[Topical immunotherapy with BCG in the adjuvant treatment of superficial bladder tumors--15-year-experience].

Between September 1984 and June 1999 we applied a long-term (3 years) protocol treatment (Pasteur strain produced by Cantacuzino Institute) in superficial bladder tumors (SBT) recurrence prophylaxis. In 1014 cases (pTa--11 cases, pT1G1--607 cases, pT1G2--149 cases, pT1G3--247 cases) our retrospective analysis used a personal protocol: 8 weekly intravesical instillations, then monthly instillations until 1 year, then 3 monthly instillations during the following 2 years. Pathologic bladder mucosa (simple, moderate and severe dysplasia, carcinoma in situ) was associated in over 80% of cases. Mean follow-up period was 118 months (range 174 to 6 months). Our results demonstrated the efficiency of this protocol (29.5% recurrences on 840 cases who had complete therapy). The importance of tumoral grading was clearly found: 13% recurrence rate for pT1G1, 39.5% for pT1G2 and 49% for pT1G3. Side-effects (local--78%, systemic--4%) and complications (3%) were treated by symptomatic or antituberculous drugs. Our significative study revealed that intravesical immunotherapy (with BCG vaccine) can be considered the first choice in the complementary treatment of SBT.