Long-term Follow-up of Primary Carcinoma In Situ of the Bladder

Summary:

We analyzed 10 patients with primary carcinoma in situ of the bladder whose follow-up period is longer than 5 years. They had neither past history of bladder cancer nor overt tumor in cystoscopy. Most patients complained of irritative vesical symptoms such as painful urination and pollakisuria. Primary cystectomy was performed in 4 patients and primary intravesical chemotherapy or immunotherapy was performed in 6 patients. When invasive bladder cancer developed in patients undergoing primary intravesical chemotherapy or immunotherapy, secondary cystectomy was performed. In all 4 patients undergoing intravesical chemothrapy, invasive bladder cancer developed 6 months to 3 years later. Also in 2 patients undergoing intravesical immunotherapy with bacillus Calmette-Guérin, invasive bladder cancer developed 2 years and 7 years later. Thus, eventually every patient needed cystectomy. Invasion occurred into the bladder wall in 3 patients, into the prostate in 2 patients, and into both bladder wall and prostate in 1 patient. Although intravesical BCG therapy is the first line treatment for patients with CIS of the bladder, close follow-up is necessary and timely cystectomy is recommended when tumor progression is suspected.

Key words:

Primary carcinoma in situ of the bladder - Follow-up study - Intravesical chemotherapy - Intravesical immunotherapy - Bacillus Calmette-Guérin