Bacillus Calmette-Guérin Perfusion Treatment via Cutaneous Ureterostomy for Carcinoma in Situ of the Upper Urinary Tract

T. Umemoto, K. Oda, T. Kano, Hakushi Kim, Hidenori Zakoji, A. Miyajima
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Abstract

Bacillus Calmette-Guérin instillation is an established therapy for the treatment of carcinoma in situ of the upper urinary tract. A 72-year-old woman underwent radical cystectomy with cutaneous ureterostomy for invasive bladder cancer with carcinoma in situ of both ureters. For the treatment of upper urinary tract carcinoma in situ, an infusion of 40 mg bacillus Calmette-Guérin through each ureterostomy was performed once weekly for 5 times. Urine cytology of the left upper urinary tract became negative, with a recurrence-free survival of 4 months. On the other hand, the right upper urinary tract became temporarily negative but turned positive after 3 months. Bacillus Calmette-Guérin perfusion therapy via cutaneous ureterostomy is considered as one of the useful therapies for carcinoma in situ of the upper urinary tract. Furthermore, there are several factors to be discussed, including the treatment duration, dosage and secondary therapeutic options.
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皮肤输尿管造口术灌注卡介苗-谷氨酰胺治疗上尿路原位癌
卡介苗-谷氨酰胺滴注是治疗上尿路原位癌的一种既定疗法。一位72岁的女性因浸润性膀胱癌合并双输尿管原位癌接受根治性膀胱切除术并皮肤输尿管造口术。治疗上尿路原位癌,每周1次输尿管造口输注卡介苗芽孢杆菌40 mg,共5次。左上尿路尿细胞学检查为阴性,无复发生存期为4个月。另一方面,右上尿路暂时呈阴性,但3个月后转为阳性。经皮肤输尿管造口卡介苗-谷氨酰胺灌注治疗是治疗上尿路原位癌的有效方法之一。此外,还有几个因素需要讨论,包括治疗时间,剂量和二次治疗选择。
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7
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