Is BCG better than MMC in preventing progressive disease in patients with superficial bladder cancer? The jury is still out.

Griffiths, Gareth, MD., Shelley, RJ., Sylvester and LA., Stewart (2004) Is BCG better than MMC in preventing progressive disease in patients with superficial bladder cancer? The jury is still out. Urology, 686-687.

Abstract

Many patients with superficial bladder cancer can be treated
relatively conservatively, perhaps by transurethral resection
(TUR) alone or in combination with simple, nontoxic intravesical
chemotherapy. However, a small proportion of patients
have disease that has a high risk of progression to invasive
or metastatic disease. In these patients, it is entirely
reasonable to ask whether more aggressive early treatment,
such as BCG can prevent disease progression. Several randomized
trials have demonstrated that intravesical BCG reduces
superficial recurrences in patients with superficial bladder
cancer.1 The data on whether BCG reduces invasive recurrence
or metastatic disease is less clear, mainly because individual
randomized trials have been too small to confirm or
refute any realistic benefits reliably. In an effort to increase the
statistical power, two meta-analyses have been performed.

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Contributors

Author: Gareth Griffiths

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