Effect of Thiotepa and BCG on Ta/Tl Bladder Tumors and Follow-up Rates

The efficacy and follow-up rate of intravesical therapy after transurethral resec-tion with thiotepa or bacillus Calmette-Guerin(BCG) for Ta/T1 transitional cell carcinoma of bladder was evaluated in 67 patients.

After transurethral resection, thiptepa(60mg) or BCG(120mg, 5×10⁸CFU/mg) was instillated into bladder every week. After 6 consecutive cycles were complicated, treatment results were evaluated with cystoscopy, urine cytology and biopsy of bladder mucosa. Disease free and follow-up rates were expressed with Kaplan-Meier curve and the treatment results were compared.

The effects of treatments were similar in both thiotepa and BCG groups. Overall, disease free rates at 1,2,3,4 and 5 years were 84, 72, 69, 65 and 42% respectively. Follow-up rates of the patients at the same periods were 55, 34, 28, 19 and 14% respectively. Mean time to progression to invasive cancer was significantly shorter than that of simple recurrence(p<0.05).

Intravesical therapy seems to be effective on the prevention of recurrence, re-gardless of the regimen of Ta/T1 bladder cancer. But the long term effect and the preventive role on progression of superficial bladder tumor should be established. In reality, the main lim-iting factor in the management of superficial bladder tumor is extremely high rate of follow-up loss.