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01.09.2016 | UROSURGERY (J COLLINS, SECTION EDITOR) | Ausgabe 9/2016 Open Access

Current Urology Reports 9/2016

High-Risk Non-Muscle-Invasive Bladder Cancer—Therapy Options During Intravesical BCG Shortage

Current Urology Reports > Ausgabe 9/2016
Rajan Veeratterapillay, Rakesh Heer, Mark I. Johnson, Raj Persad, Christian Bach
Wichtige Hinweise
This article is part of the Topical Collection on Urosurgery


Bladder cancer is the second commonest urinary tract malignancy with 70–80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with high grade/G3, or CIS) represent a challenging group as they are at greater risk of recurrence and progression. Intravesical Bacilli Calmette-Guerin (BCG) is commonly used as first line therapy in this patient group but there is a current worldwide shortage. BCG has been shown to reduce recurrence in high-risk NMIBC and is more effective that other intravesical agents including mitomycin C, epirubicin, interferon-alpha and gemcitabine. Primary cystectomy offers a high change of cure in this cohort (80–90 %) and is a more radical treatment option which patients need to be counselled carefully about. Bladder thermotherapy and electromotive drug administration with mitomycin C are alternative therapies with promising short-term results although long-term follow-up data are lacking.

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