Complications of postoperative intrapleural BCG in lung cancer

Sixty-four patients received bacillus Calmette- Guérin (BCG) in different dosages intrapleurally through a chest drain following resection for lung cancer. In 27 patients this procedure was followed by fever for a few days; the fever was attributed to the BCG. Late complications attributable to the BCG included recurrent fever in 4 patients, abscesses at the site of the drain in 4, wound infections in 2, consolidations on the chest roentgenogram in 3, 1 of whom had subsequent cavitation, and hemoptysis in 2. Side-effects were not dose-dependent. No relationship was found between the preoperative tuberculin response and the frequency or severity of complications. Treatment with isoniazid and rifampin failed to induce an apparent clinical response in patients with complications. We conclude that the intrapleural administration of BCG is not a safe procedure. The side-effects may considerably impair the patient's quality of life.