Initial adjuvant immunotherapy trials have demonstrated a greater disease-free 
interval in patients treated with bacille Calmette-Guérin (BCG) compared with 
historical controls. In this study 149 patients at high risk of recurrence after 
surgical treatment of local or regional malignant melanoma were given BCG for 2 
years and were followed up for a median of 28 months from the start of 
immunotherapy. The 36 patients in the comparison group had a higher rate of 
recurrence than the patients treated with BCG, and the rate in the treatment 
group was close to that reported from a similar study at the University of 
California at Los Angeles. The relatively long disease-free interval for the 
high-risk comparison patients in this study suggests that the control groups at 
other centres may have included patients with unrecognized additional risk. The 
rates of survival in the Canadian treatment group were also comparable to those 
reported by other centres. However, reports of a favourable BCG-mediated pattern 
of recurrence could not be confirmed. Therefore, the routine use of adjuvant BCG 
immunotherapy is not recommended.