Patients with a so-called BCG failure (Bacillus Calmette-Guérin) constitute an inhomogeneous group of patients.
Patients with BCG recurrence or BCG refractive tumors are real BCG failures. Therapeutic options are radical cystectomy and a conservative approach, depending on the individual risk of recurrence and progression. Intravesical chemotherapy with docetaxel or gemcitabine after BCG failure shows some promise whereas second line immunotherapy, the combination of BCG and interferon (INF)-α, is an effective regimen but results need to be confirmed. Device-assisted intravesical strategies, such as mitomycin-EMDA or chemohyperthermia are candidates to keep in mind for the near future. Finally, cystectomy results in the best disease-specific survival in patients with BCG failure.
Written by:
Laturnus JM, Jocham D, Sommerauer M. Are you the author?
Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein - Campus Luebeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Reference: Urologe A. 2012 May 13. Epub ahead of print.
doi: 10.1007/s00120-012-2875-9
PubMed Abstract
PMID: 22580923
Article in German.
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