Evolution of carcinoma in situ under intravesical Romanian Bacille Calmette-Guérin therapy

We analysed the evolution of 33 cases with carcinoma in situ (Cis) of the urinary bladder using the intravesical Bacille Calmette-Guérin (BCG) therapy (2 cases with primary Cis, 20 cases discovered at 4 quadrant biopsies within surgical treatment of superficial bladder tumours and 5 cases discovered at 3 monthly evaluation cystoscopy and chromocystoscopy). The mean period of follow-up was 40 months. Our protocol of immunotherapy was maintained for 3 years (8 weekly instillations with 100 mg Romanian--modified Pasteur BCG vaccine in 50 ml of saline, followed by monthly instillations for 10 months and then 3 monthly instillations for 2 years with the same doses). We described the great importance of this "long-course treatment": 12 cases with persistent Cis after 6 months and 2 cases with persistent Cis after 21 months. During September 1984-August 1990 we registered 6 invasive tumours (18.18%). These results showed the dynamic evolution of Cis under long-term intravesical immune BCG stimulation.