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Intravesical BCG

Suk Young Lee, Sang Hee Choi
Intravesical BCG therapy after transurethral resection of bladder tumor (TURB) is considered the most effective treatment for prophylaxis against the recurrence of high risk non-muscle invasive bladder cancer, and generally well tolerated and infectious complication are rare. We reported a case of granulomatous prostatitis is a patient who had undergone intravesical BCG therapy due to non-invasive superficial urothelial carcinoma of bladder. This patient was diagnosed by prostate biopsy because of PSA elevation without any other voiding symptoms and abnormal abscess pocket in transrectal ultrasonography...
March 2018: Urology Case Reports
Islam M El-Babouly, Esam A E Desoky, Diab El Sayed, Maged M Ali, Ola A Harb, Ahmed Ragab, Ahmed M Sakr, Amr M Fawzi, Nashaat M Salama, Ibrahim I Samaha
OBJECTIVE: To report the sensitivity and specificity of neural precursor cell-expressed developmentally down-regulated protein 9 (NEDD9) protein high expression in predicting BCG response and its effect on recurrence or progression free survivals. PATIENTS AND METHODS: Between May 2014 and April 2017, a prospective cohort study was conducted on 105 patients with intermediate or high-risk nonmuscle invasive bladder cancer. Immunohistochemical staining with mouse monoclonal anti-NEDD9 antibody was done...
March 5, 2018: Urologic Oncology
David D Andrea, Mohammad Abufaraj, Martin Susani, Robin Ristl, Beat Foerster, Shoji Kimura, Andrea Mari, Francesco Soria, Alberto Briganti, Pierre I Karakiewicz, Killian M Gust, Morgan Rouprêt, Shahrokh F Shariat
PURPOSE: To improve current prognostic models for the selection of patients with T1G3 urothelial bladder cancer who are more likely to fail intravesical therapy and progress to muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: We performed a retrospective analysis of 1,289 patients with pT1G3 urothelial bladder cancer who were treated with transurethral resection of the bladder (TURB) and adjuvant intravesical bacillus-Calmette-Guérin (BCG). Random-split sample data and competing-risk regression were used to identify the independent impact of lymphovascular invasion (LVI) and variant histology (VH) on progression to MIBC...
March 2, 2018: Urologic Oncology
Siteng Chen, Ning Zhang, Jialiang Shao, Xiang Wang
BACKGROUND: It is not clear whether maintenance Bacillus Calmette-Guerin (BCG) is necessary for intermediate- or high-risk non-muscle-invasive bladder cancer (NMIBC). This systematic review and meta-analysis aimed to illustrate the effects of maintenance BCG for intermediate- or high-risk NMIBC. METHODS: A comprehensive literature search of PubMed, EMBASE, Cochrane Library, databases and International Clinical Trials Register (ICTRP) Search was conducted to identify relevant randomized controlled trials (RCTs) that have assessed the efficacy of maintenance or non-maintenance BCG therapy for patients with NMIBC...
February 28, 2018: International Journal of Surgery
Rumman Ahmed, Konrad Wolfe, Peter Acher, Sidath Liyanage
Granulomatous bacillus Calmette-Guérin (BCG) infection, both localized and disseminated, as a complication of intravesical therapy for transitional cell carcinoma of the bladder is a recognized but highly unusual phenomenon. We report the case of an 89-year-old gentleman with a history of bladder transitional cell carcinoma and subsequent intravesical BCG instillation of the bladder who presented to his general practitioner with a non-tender lump in his left testis. Histopathologic and microbiological evaluation of the subsequent orchidectomy specimen revealed granuloma formation secondary to BCG infection...
December 2017: Radiology Case Reports
Roberto Giulianelli, Barbara Cristina Gentile, Gabriella Mirabile, Luca Albanesi, Paola Tariciotti, Giorgio Rizzo, Maurizio Buscarini, Mauro Vermiglio
INTRODUCTION: Understaging after initial transurethral resection is common in patients with high-risk non muscle infiltrating bladder cancer (NMIBC) and can delay accurate diagnosis and definitive treatment. The rate of upstaging from T1 to T2 disease after repeated transurethral resection ranges from 0 to 28%, although the rate of upstaging may be even higher up to 49% when muscularis propria is absent in the first specimen. A restaging classic transurethral resection of bladder tumour (re-cTURBT) is the better predictor of early stage progression...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
Yusuke Iemura, Shinji Fukui, Yoshiaki Matsumura, Yoriaki Kagebayashi, Yuta Toyoshima, Takeshi Inoue, Shoji Samma
A 69-year-old man received transurethral resection (TUR) ofbladder tumor. The histopathological diagnosis was urothelial carcinoma, high grade, pT1+pTis. The surgical specimens obtained by second TUR showed no residual malignancy histopathologically. Intravesical Bacillus Calmette-Guerin (BCG) instillation therapy was initiated 2 months after the second TUR. He complained of lower abdominal pain and painful urination on the day following the second instillation of BCG. Computed tomography and cystography demonstrated rupture ofthe urinary bladder...
January 2018: Hinyokika Kiyo. Acta Urologica Japonica
Yosra Selmi, Rania Kheder-Elfekih, Hela Jebali, Lilia Ben Fatma, Wided Smaoui, Madiha Krid, Soumaya Beji, Lamia Rais, Mohamed Karim Zouaghi
Various adverse reactions may occur after intravesical bacillus Calmette-Guérin (BCG) therapy. Although the virulence of attenuated BCG is low, serious complications such as bacterial cystitis, bladder contractures, granulomatous prostatitis, epididymitis, orchitis, and systemic reactions such as fever and malaise have been described. Disseminated granulomatosis such as hepatitis and pneumonitis have also been described, but are rare. We report here the case of a 67-year-old patient who presented with renal granulomatosis with polyangiitis following intravesical BCG therapy for superficial bladder tumor...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Neelam Mukherjee, Robert S Svatek, Ahmed M Mansour
Intravesical instillation of live attenuated bacillus Calmette-Guérin (BCG) is the gold standard for patients with intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC). BCG-failures include a heterogenous population of patients who share a designation of disease recurrence or progression following BCG and include patients with complete unresponsiveness to BCG, patients who respond initially but develop relapse and, in some cases, patients who are intolerant to BCG due to side effects. Given the efficacy and relatively rapid approval of several monoclonal antibodies against PD-L1 or PD-1 for advanced and metastatic bladder cancer, the role of these checkpoint inhibitors in BCG-relapsing disease at various disease stages is under consideration...
February 8, 2018: Urologic Oncology
Francesca Sanguedolce, Antonella Cormio, Paolo Massenio, Maria C Pedicillo, Simona Cagiano, Francesca Fortunato, Beppe Calò, Giuseppe Di Fino, Giuseppe Carrieri, Pantaleo Bufo, Luigi Cormio
PURPOSE: The identification of factors predicting the outcome of stage T1 high-grade bladder cancer (BC) is a major clinical issue. METHODS: We performed immunohistochemistry to assess the role of human epidermal growth factor receptor-2 (HER-2) and microsatellite instability (MSI) factors MutL homologue 1 (MLH1) and MutS homologue 2 (MSH2) in predicting recurrence and progression of T1 high-grade BCs having undergone transurethral resection of bladder tumor (TURBT) alone or TURBT + intravesical instillations of bacillus Calmette-Guerin (BCG)...
January 23, 2018: Journal of Cancer Research and Clinical Oncology
S Poletajew, R Biernacki, P Buraczynski, J Chojnacki, S Czarniecki, D Gajewska, T Pohaba, J Sondka-Migdalska, M Skrzypczyk, T Suchojad, D Wojtkowiak, B Zaforemski, L Zapala, A Zemla, P Radziszewski
Adjuvant diagnostic and therapeutic procedures are available to reduce the risk of recurrence or progression in patients with high-risk non-muscle-invasive bladder cancer (NMIBC). However, their indications and efficacy remain a matter of debate. The aim of this study was to analyze therapeutic decisions in patients with primary high-risk NMIBC and to analyze the adherence to clinical guidelines in this field.545 consecutive patients, aged a median of 70.3 years, diagnosed with primary high-risk NMIBC in thirteen urological institutions, were enrolled into this retrospective study...
2018: Neoplasma
Nkwam Nkwam, Shaun Trecarten, Stefan Momcilovic, Alvaro Bazo, Gurminder Mann, Benedict Sherwood, Richard Parkinson
OBJECTIVE: To establish whether the regular biopsy of red patches (RPs) seen during endoscopic surveillance for bladder cancer is worthwhile and determine a suitable time frame for repeat biopsy of prior histologically benign persistent RPs in patients on endoscopic surveillance for bladder cancer. PATIENTS AND METHODS: Four thousand eight hundred five flexible cystoscopy (FC) reports over a 12-month period were retrospectively reviewed at a United Kingdom tertiary teaching hospital and those undergoing cystoscopic surveillance for bladder cancer and found to have solitary RPs at FC were included in the study...
February 1, 2018: Journal of Endourology
Giorgio Calleris, Giancarlo Marra, Silvia Corcione, Marco Oderda, Chiara Cardellino, Sabrina Audagnotto, Bruno Frea, Francesco Giuseppe De Rosa, Paolo Gontero
Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy decreases the progression risk of non-muscle-invasive bladder cancer, but potentially yields a broad spectrum of side effects. We report the case of a 73-year-old man affected by miliary pulmonary BCG infection, whose microbiological diagnosis was probably hindered by empiric fluoroquinolones, focusing on imaging and clinical work-up.
December 1, 2017: Le Infezioni in Medicina
Makito Miyake, Yoshihiro Tatsumi, Hiroaki Matsumoto, Kazuhiro Nagao, Hideyasu Matsuyama, Teruo Inamoto, Haruhito Azuma, Hiroaki Yasumoto, Hiroaki Shiina, Kiyohide Fujimoto
OBJECTIVES: To describe the clinicopathologic characteristics and prognosis of subsequent non-muscle invasive bladder cancer (NMIBC) after radical nephroureterectomy for upper urinary tract urothelial carcinoma (UTUC), particularly its response to intravesical Bacillus Calmette-Guérin (BCG). PATIENTS AND METHODS: An observational study was conducted in 1463 patients with UTUC who had undergone radical nephroureterectomy and in 1555 patients with primary NMIBC. Of the 1463 UTUC patients, 256 (17%) subsequently developed NMIBC (UTUC-NMIBC) and were available for the analysis...
December 27, 2017: BJU International
Azharuddin Mohammed, Zubair Arastu
BACKGROUND: Intravesical Bacilli Calmette-Guerin (IVBCG) therapy for non-muscle invasive bladder cancer (NMIBC) has long been in use successfully. Albeit rarely, we still face with its safety concerns more than 25 years on since its approval by US Food and Drug Agency in 1990. Local and systemic infection following intravesical BCG is widely reported as compared to immune mediated local or systemic hypersensitivity reactions involving kidneys; acute kidney injury (AKI) and other renal manifestations are well reported but not of chronic kidney disease (CKD)...
December 6, 2017: BMC Urology
Gabriela R Passos, Juliana A Camargo, Karen L Ferrari, Mário J A Saad, Amilcar C de Mattos, Leonardo O Reis
The aim of this study was to explore the efficacy of intravesical Thalidomide (immunomodulatory, anti-inflammatory and anti-angiogenic) added to BCG using an immune competent autochthonous orthotopic NMIBC animal model. Female Fischer 344 rats, 7 weeks of age, received every 2 weeks for four times, a dose of 1.5 mg/kg of N-methyl-N-nitrosourea (MNU) intravesically. The rats were randomized into four groups (n = 10 per group) to receive intravesical treatment once a week for 6 weeks as follows: control (0...
December 4, 2017: Medical Oncology
Öner Şanlı, Yair Lotan
Bladder cancer (BC) is one of the leading causes of cancer-related deaths worldwide. Despite, the majority of the cases were diagnosed as non-muscle invasive bladder cancer (NMIBC) with favorable prognosis, it has tendency to recur or progress to a higher grade or stage. The first line treatment of patients with NMIBC is transurethral resection with adjuvant therapies primarily intravesical Bacillus Calmette-Guérin (BCG) immunotherapy. However, in a portion of patients whose BCG treatment failed, alternative treatments may be required...
December 2017: Turkish Journal of Urology
Juliana A Camargo, Gabriela R Passos, Karen L Ferrari, Athanase Billis, Mário J A Saad, Leonardo O Reis
BACKGROUND: The Toll-like receptor (TLR)2/4 agonist bacillus Calmette-Guérin (BCG), although not failure proof, has been the most efficient immunomodulatory treatment of immunogenic nonmuscle-invasive bladder cancer (NMIBC) for > 40 years. We investigated the role of the immunomodulatory molecule TLR7 agonist imiquimod through the BCG key receptors TLR2/4 and the main downstream molecules of the mammalian target of rapamycin pathway in NMIBC treatment. MATERIALS AND METHODS: A total of 40 Fischer-344 rats, 7 weeks old, received 4 doses of 1...
November 7, 2017: Clinical Genitourinary Cancer
Thiru Prasanna, Paul Craft, Gayathri Balasingam, Hodo Haxhimolla, Ganes Pranavan
Background: Intravesical Bacillus Calmette-Guérin (BCG) remains the standard adjuvant treatment for non-muscle invasive bladder cancer (NMIBC) following transurethral resection; however, BCG failure and related toxicities are common. Objectives: To compare the efficacy and toxicity of intravesical BCG and gemcitabine in the treatment of NMIBC. Methods: Retrospective data were collected in the region of Canberra, Australia from January 2010 to December 2015...
2017: Frontiers in Oncology
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