BCG in the management of superficial bladder cancer

An overall comparison of different types of therapy for any disease is difficult. A definition of the disease, which included carcinoma in situ was not agreed upon in 1961 when thiotepa was first described. Most importantly, many series are not prospective and randomized. Response criteria have varied and have not always included cytologies. With these shortcomings in mind we have attempted to compare the various therapeutic agents. The response rate for BCG appears superior to chemotherapy for the treatment of superficial bladder cancer (59% vs 45%), for prophylaxis (77% vs 53%) and the management of carcinoma in situ (74% vs 52%). Moreover BCG also appears superior to chemotherapy for the management of prior treatment failures, particularly carcinoma in situ. In summary, this review of the literature suggests that BCG is superior, in terms of response rate, to available chemotherapy in the management of superficial bladder cancer.