A patient with transitional cell carcinoma (TCC) of the bladder, T1G3 (high-grade) confirmed on TURBT, is planned for intravesical BCG immunotherapy. BCG induction course consists of:

• A 4 instillations over 4 weeks, then quarterly for 2 years
• B Single instillation at time of TURBT
• C 12 monthly instillations for 1 year
• D 6 weekly instillations followed by 3-weekly maintenance for 1–3 years ✓

Explanation

BCG induction for high-risk non-muscle-invasive bladder cancer (T1G3, high-grade, or CIS) consists of 6 weekly intravesical instillations (induction course), followed by maintenance BCG using Lamm's protocol: 3 weekly instillations at 3, 6, 12, 18, 24, 30, and 36 months (3-year maintenance). This maintenance protocol significantly reduces recurrence and progression to muscle invasion. Single instillation immediately post-TURBT is used for low/intermediate risk with mitomycin C, not BCG.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.