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Intravesical Bacillus Calmette-Guérin treatment for superficial bladder cancer: results after 15 years of experience.

Superficial bladder cancer has a high recurrence rate and considerable progression rate. The treatment currently consists of resection and adjuvant intravesical chemotherapy or immunotherapy. Intravesical instillation of Bacillus Calmette-Guérin (B.C.G.) is considered to be one of the most successful immunotherapies in man. Durable response rates of 60-70% are achieved. Toxicity is more pronounced in comparison with intravesical chemotherapy. In this article we describe the experience with B.C.G. during the last 15 years. No consensus has been reached yet about the ideal treatment scheme, appropriate strain and optimal dosage. The mechanisms of action are complicated and still not completely understood.