No abstract

We retrospectively reviewed consecutive 40 patients who had received BCG therapy for UUT CIS (49 renal units: RUs) in our institute. UUT CIS was defined as positive cytology in urine from selective retrograde UUT catheter and no detectable lesion on UUT imaging. BCG delivery was accomplished by retrograde and antegrade instillation and a treatment course consisted of 8 weekly instillations.RESULTS: Forty seven and 2 RUs were treated by retrograde and antegrade instillation, respectively. The cytology became negative in 42 RUs (85.7%) after 1st course. Of remaining 7 RUs, 4 RUs received 2nd course of BCG therapy and the urine cytology became negative in 2 RUs (50.0%).At median follow-up of 23 (range 8-113) months, recurrence occurred in 10 of 42 RUs (23.8%) after 1st course. Seven of 10 RUs received 2nd course, cytology became negative in 5 of 7 RUs (71.4%).Progression to T1 developed in 6 RUs. Of them, 4 RUs underwent nephroureterectomy and survived without recurrence. Only 1 patient who did not underwent nephroureterectomy died of cancer progression. Kidneypreservation rate was 73.5% (36 of 49 RUs). Recurrence-and progressionfree survival was not reached median value during follow-up period. Age, presence of concomitant bladder cancer, BCG strain and dose, instillation volume and a number of instillations were not associated with recurrence. Treatment was tolerable in most patients, but severe contracted bladder and renal dysfunction occurred in 2 and 1 patients, respectively.CONCLUSIONS: BCG therapy was effective for UUT CIS and resulted in a high renal unit-preservation rate. Adverse events were acceptable but attention should be paid to severe bladder contraction and renal dysfunction.

Presentamos nuestro protocolo de tratamiento para el epitelioma de labio. según comprometa un tercio, dos tercios de extensión o todo el labio. También se presenta una técnica personal para aquellos epiteliomas que comprometen todo el labio. Nuestra casuística se inicia en 1980 y se han intervenido hasta el presente 240 epiteliomas de labio.