D Zaak1, C Ohlmann2, A Stenzl3. 1. Urologie Traunstein, Traunstein, Deutschland. 2. Klinik für Urologie, Malteser Krankenhaus Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Deutschland. 3. Universitätsklinikum Tübingen, Klinik für Urologie, Eberhard-Karls-Universität Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland. arnulf.stenzl@med.uni-tuebingen.de.
Abstract
INTRODUCTION: In this paper, current guidelines regarding diagnostic and staging modalities of urothelial cancer of the bladder are summarized and an overview of endoscopic, imaging, and molecular methods currently being tested are outlined. METHODS: Relevant passages from current guidelines and recent literature as well as to a certain extent our own research are examined. RESULTS: Over the last decade, imaging mainly in the form of photodynamic diagnosis (PDD) has undergone further development and found its way into several guidelines. PDD-based transurethral resection of the bladder (TURB) proved to have a long-term effect regarding recurrence rate, progression and reduction of cystectomy in some patients. More light-filtering techniques and improvements in the screen resolution are currently being clinically tested. Molecular substaging using combinations of immunohistochemical biomarkers has the potential to change the clinical management of advanced urothelial cancer. CONCLUSION: New visualization techniques are likely to improve recurrence intervals and prognosis of bladder cancer. Molecular substaging will revolutionize prognostic assessment and therapeutic strategies of urothelial cancer.
INTRODUCTION: In this paper, current guidelines regarding diagnostic and staging modalities of urothelial cancer of the bladder are summarized and an overview of endoscopic, imaging, and molecular methods currently being tested are outlined. METHODS: Relevant passages from current guidelines and recent literature as well as to a certain extent our own research are examined. RESULTS: Over the last decade, imaging mainly in the form of photodynamic diagnosis (PDD) has undergone further development and found its way into several guidelines. PDD-based transurethral resection of the bladder (TURB) proved to have a long-term effect regarding recurrence rate, progression and reduction of cystectomy in some patients. More light-filtering techniques and improvements in the screen resolution are currently being clinically tested. Molecular substaging using combinations of immunohistochemical biomarkers has the potential to change the clinical management of advanced urothelial cancer. CONCLUSION: New visualization techniques are likely to improve recurrence intervals and prognosis of bladder cancer. Molecular substaging will revolutionize prognostic assessment and therapeutic strategies of urothelial cancer.
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