Nichtmuskelinvasives Urothelkarzinom: Ist die Anwendung von BCG noch notwendig?

Patients with non-muscle-invasive transitional cell carcinoma are treated in a risk-adopted fashion. Genetically stable low-grade tumors are treated with transurethral resection followed by optional intravesical treatment to prevent tumor recurrence. In cases of high-grade tumors, transurethral resection is followed by a second resection after 4-6 weeks. For patients with carcinoma in situ or high-grade T1 carcinomas, guidelines recommend BCG treatment to prevent recurrence and progression. These recommendations are based on meta-analyses resulting in a 4% reduction of tumor progression. Results published in 2009 and 2010 critically analyze BCG treatment of high-grade bladder tumors and are the focus of this article.