The role of BCG in the treatment of superficial bladder cancer

Intravesical therapy for superficial transitional cell carcinoma (TCC) of the urinary bladder (i.e. Ta, T1, and carcinoma in situ) is intended to treat existing or residual tumor, to prevent recurrence of tumor, to prevent progression of disease and to prolong survival of patients. Intravesical chemotherapy has resulted in a reduction in short-term tumor recurrence rates, but has had no positive impact on disease progression or prolongation of survival. Presently, BCG immunotherapy remains the most effective treatment and prophylaxis for superficial TCC and has a positive impact on tumor recurrence rate, disease progression and prolongation of survival. Proper attention to maintenance schedules, route of administration, dosing, strains and viability is essential to obtain the maximum benefits of BCG immunotherapy. This review highlights and summarizes the recent advances concerning BCG therapy in treatment and prophylaxis of TCC.