CONTEXT AND OBJECTIVE: To present the updated version of 2008 European Association of Urology (EAU) guidelines on non-muscle-invasive bladder cancer. EVIDENCE ACQUISITION: A systematic review of the recent literature on the diagnosis and treatment of non-muscle-invasive bladder cancer was performed. The guidelines were updated and the level of evidence and grade of recommendation were assigned. EVIDENCE SYNTHESIS: The diagnosis of bladder cancer depends on cystoscopy and histologic evaluation of the resected tissue. A complete and correct transurethral resection (TUR) is essential for the prognosis of the patient. When the initial resection is incomplete or when a high-grade or T1 tumour is detected, a second TUR within 2-6 wk should be performed. The short- and long-term risks of both recurrence and progression may be estimated for individual patients using the scoring system and risk tables. The stratification of patients to low, intermediate, and high-risk groups-separately for recurrence and progression-represents the cornerstone for indication of adjuvant treatment. In patients at low risk of tumour recurrence and progression, one immediate instillation of chemotherapy is strongly recommended. In those at an intermediate or high risk of recurrence and an intermediate risk of progression, one immediate instillation of chemotherapy should be followed by further instillations of chemotherapy or a minimum of 1 yr of bacillus Calmette-Guerin (BCG). In patients at high risk of tumour progression, after an immediate instillation of chemotherapy, intravesical BCG for at least 1 yr is indicated. Immediate cystectomy may be offered to the highest risk patients and in patients with BCG failure. The long version of the guidelines is available on www.uroweb.org. CONCLUSIONS: These EAU guidelines present the updated information about the diagnosis and treatment of non-muscle-invasive bladder cancer and offer the recent findings for the routine clinical application.
CONTEXT AND OBJECTIVE: To present the updated version of 2008 European Association of Urology (EAU) guidelines on non-muscle-invasive bladder cancer. EVIDENCE ACQUISITION: A systematic review of the recent literature on the diagnosis and treatment of non-muscle-invasive bladder cancer was performed. The guidelines were updated and the level of evidence and grade of recommendation were assigned. EVIDENCE SYNTHESIS: The diagnosis of bladder cancer depends on cystoscopy and histologic evaluation of the resected tissue. A complete and correct transurethral resection (TUR) is essential for the prognosis of the patient. When the initial resection is incomplete or when a high-grade or T1 tumour is detected, a second TUR within 2-6 wk should be performed. The short- and long-term risks of both recurrence and progression may be estimated for individual patients using the scoring system and risk tables. The stratification of patients to low, intermediate, and high-risk groups-separately for recurrence and progression-represents the cornerstone for indication of adjuvant treatment. In patients at low risk of tumour recurrence and progression, one immediate instillation of chemotherapy is strongly recommended. In those at an intermediate or high risk of recurrence and an intermediate risk of progression, one immediate instillation of chemotherapy should be followed by further instillations of chemotherapy or a minimum of 1 yr of bacillus Calmette-Guerin (BCG). In patients at high risk of tumour progression, after an immediate instillation of chemotherapy, intravesical BCG for at least 1 yr is indicated. Immediate cystectomy may be offered to the highest risk patients and in patients with BCG failure. The long version of the guidelines is available on www.uroweb.org. CONCLUSIONS: These EAU guidelines present the updated information about the diagnosis and treatment of non-muscle-invasive bladder cancer and offer the recent findings for the routine clinical application.
Authors: Meng Chen; Michelle A T Hildebrandt; Jessica Clague; Ashish M Kamat; Antoni Picornell; Joshua Chang; Xiaofan Zhang; Julie Izzo; Hushan Yang; Jie Lin; Jian Gu; Stephen Chanock; Manolis Kogevinas; Nathaniel Rothman; Debra T Silverman; Montserrat Garcia-Closas; H Barton Grossman; Colin P Dinney; Núria Malats; Xifeng Wu Journal: Cancer Prev Res (Phila) Date: 2010-09-21
Authors: Carolina Rubio; José Avendaño-Ortiz; Raquel Ruiz-Palomares; Viktoriya Karaivanova; Omaira Alberquilla; Rebeca Sánchez-Domínguez; José Carlos Casalvilla-Dueñas; Karla Montalbán-Hernández; Iris Lodewijk; Marta Rodríguez-Izquierdo; Ester Munera-Maravilla; Sandra P Nunes; Cristian Suárez-Cabrera; Miriam Pérez-Crespo; Víctor G Martínez; Lucía Morales; Mercedes Pérez-Escavy; Miguel Alonso-Sánchez; Roberto Lozano-Rodríguez; Francisco J Cueto; Luis A Aguirre; Félix Guerrero-Ramos; Jesús M Paramio; Eduardo López-Collazo; Marta Dueñas Journal: Cancers (Basel) Date: 2022-01-07 Impact factor: 6.639