[Preliminary results in treating superficial bladder tumors by the local instillation of Calmette-Guérin bacilli].

Abstract

Post-resection complementary immunotherapy was applied to 55 patients with superficial urinary bladder tumours (Ta, TI) with Calmette-Guérin bacilli (Pasteur strain) prepared by the "Cantacuzino" Institute. The treatment consisted initially in scarification and instillation in 19 patients, and in instillation alone inside the urinary bladder in 43 patients, according to Morales, and respectively Brosman protocols. In 7 patients only Morales immunotherapy was applied initially but after recidive and resection they too were treated according to the Brosman protocol. One should note that most of these tumours were of the recurring type, with multiple recidives in the antecedents in 60% of the patients, and that the surgical treatment, as well as instillation of cytostatic drugs had failed. In the present protocol transurethral resection was carried out in 93% of the cases. After immunotherapy the following aspects were noted: in 75.8% of the patients there were no recidives 25 months in the average after the start of the treatment. In the average 13 months elapsed between the start of the treatment and the occurrence of the first recidive, as compared with 7 months in the average for the controls. Most of the recidives in patients with instillations occurred in those in whom the tumour had gone beyond the basal membrane. In 2 patients with infiltrative recidives total cystectomy was carried out. With regard to degree of anaplasia following BCG instillation there was a down-grading in 43% of the cases. There was no fatality ascribable to BCG treatment in our series, and both general and local complications were insignificant considering the therapeutic benefit.