What is the role of bacille Calmette-Guérin (BCG) in renal transitional cell carcinoma treatment?

Updated: Nov 05, 2019
  • Author: Bagi RP Jana, MD, MBA, MHA, FACP; Chief Editor: E Jason Abel, MD  more...
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Answer

Instillation of bacille Calmette-Guérin (BCG) through a percutaneous catheter resulted in conversion of urine cytology from positive to negative in 7 of 10 patients with upper urinary tract CIS. BCG sepsis was observed in 1 patient and was treated successfully.

Administration of BCG as a prophylactic agent after endoscopic treatment of superficial urothelial tumors resulted in a recurrence rate of 12.5% in 1 study. However, some studies reported a recurrence rate of up to 50%.

In contrast to the efficacy of BCG in bladder cancer, the ability of BCG to treat high-grade UC of the upper urinary tract or reduce the progression rate is not determined. Therefore, high-grade upper urinary tract UC requires radical surgical intervention.

A retrospective study by Rastinehad et al compared 50 cases in which adjuvant BCG was given after resection of upper urinary tract TCC with 39 control cases. In treated cases, BCG was started 2 weeks after endoscopic management and given for a total of 6 courses. The comparison showed no overall benefit from BCG with regard to disease recurrence, interval to recurrence, and progression of disease. [15]


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