J Alfred Witjes1. 1. Department of Urology, Radboudumc Nijmegen, Nijmegen, The Netherlands.
Abstract
PURPOSE OF REVIEW: Patients with nonmuscle invasive bladder cancer (NMIBC) have a high risk of recurrent tumors, even in spite of contemporary guideline recommended therapy. Follow-up recommendations are also clear (cystoscopy with cytology and upper urinary tract imaging in high-risk patients), but frequency and duration of follow-up are well defined. However, recent developments in follow-up tools might be of interest for clinical practice. RECENT FINDINGS: Enhanced endoscopy improves detection and treatment of recurrences, and it can help in tailoring follow-up. However, it remains an invasive procedure. Most recently cystoscopy augmented with artificial intelligence has shown some promising results. Active surveillance, frequently done in prostate cancer patients, is also gaining attention in NMIBC follow-up. Finally markers are being studied and launched. Although not recommended by guidelines, and not used in clinical practice, recent studies have shown marker combinations with very high negative predictive values for (high risk) recurrences in follow-up of NMIBC patients. SUMMARY: New tools for follow-up such as enhanced cystoscopy and urinary markers might help to individualize follow-up, which will result in decreasing patient discomfort, workload and costs while quality of care is maintained.
PURPOSE OF REVIEW: Patients with nonmuscle invasive bladder cancer (NMIBC) have a high risk of recurrent tumors, even in spite of contemporary guideline recommended therapy. Follow-up recommendations are also clear (cystoscopy with cytology and upper urinary tract imaging in high-risk patients), but frequency and duration of follow-up are well defined. However, recent developments in follow-up tools might be of interest for clinical practice. RECENT FINDINGS: Enhanced endoscopy improves detection and treatment of recurrences, and it can help in tailoring follow-up. However, it remains an invasive procedure. Most recently cystoscopy augmented with artificial intelligence has shown some promising results. Active surveillance, frequently done in prostate cancerpatients, is also gaining attention in NMIBC follow-up. Finally markers are being studied and launched. Although not recommended by guidelines, and not used in clinical practice, recent studies have shown marker combinations with very high negative predictive values for (high risk) recurrences in follow-up of NMIBC patients. SUMMARY: New tools for follow-up such as enhanced cystoscopy and urinary markers might help to individualize follow-up, which will result in decreasing patient discomfort, workload and costs while quality of care is maintained.
Authors: G Cancel-Tassin; M Roupret; U Pinar; C Gaffory; F Vanie; V Ondet; E Compérat; Olivier Cussenot Journal: World J Urol Date: 2021-03-26 Impact factor: 4.226
Authors: Barrett Cowan; Eric Klein; Ken Jansz; Karl Westenfelder; Timothy Bradford; Chad Peterson; Douglas Scherr; Lawrence I Karsh; Blair Egerdie; Alfred Witjes; Andrew Trainer; Richard Harris; Bernard Goldfarb; Stanley Flax; Robert Kroeger; Buffi Boyd; Joseph Liao; Sanjay Patel; Julia Bridge; Victor Reuter; Neil Quigley; Sarah Brown; Suling Zhao; Malini Satya; Michael Bates; Iris M Simon; Scott Campbell; Yair Lotan Journal: BJU Int Date: 2021-05-05 Impact factor: 5.969