Defining bacillus Calmette-Guerin refractory superficial bladder tumors

J Urol. 2003 May;169(5):1706-8. doi: 10.1097/01.ju.0000062605.92268.c6.


Purpose: We define bacillus Calmette-Guerin (BCG) refractory, high risk, superficial bladder cancer.

Materials and methods: A total of 93 patients received a 6-week induction course of BCG. They were evaluated for response after 3 and 6 months. Half of the patients received monthly maintenance BCG for 2 years and half did not. In both groups the initial responses to BCG at 3 and 6 months were correlated with subsequent tumor recurrence and progression.

Results: Of the 93 cases 57% were negative for tumor at 3 months and 43% had residual tumor resected. At 6 months 80% of the patients were tumor-free and 20% had persistent or recurrent tumor. Maintenance BCG did not decrease tumor recurrence further than induction BCG. Subsequent tumor-free interval during 24 months of followup were best predicted by response to BCG after 6 months.

Conclusions: A minimum treatment and followup time of 6 months is required to identify high risk, superficial bladder tumors as truly BCG refractory.

MeSH terms

  • Adjuvants, Immunologic / therapeutic use*
  • BCG Vaccine / therapeutic use*
  • Disease Progression
  • Drug Resistance, Neoplasm*
  • Humans
  • Time Factors
  • Urinary Bladder Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / pathology


  • Adjuvants, Immunologic
  • BCG Vaccine