Fernando Korkes1,2, Phillipe E Spiess3,4, Herney Andres Garcia-Perdomo5, Andrea Necchi6. 1. Disciplina de Urologia, Faculdade de Medicina do ABC - FMABC, Santo Andre, SP, Brasil. 2. Disciplina de Urologia do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil. 3. Department of Genito-Urinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, EUA. 4. Department of Urology and Oncology, University of South Florida University of South Florida, Tampa, FL, EUA. 5. Division of Urology / Urooncology, Department of Surgery, School of Medicine, Research Group - UROGIV, Universidad Del Valle, Cali, Colômbia. 6. Discipline of Urology, University Vita-Salute San Raffaele, Milan, Italy.
Abstract
PURPOSE: To describe the current scientific knowledge and clinical experience in low-grade-non-muscle-invasive bladder cancer (LG-NMIBC) patients in challenging scenarios. MATERIALS AND METHODS: Medline, Embase, Google Scholar, and Cochrane Central were searched until March 2021. RESULTS: A total of 841 studies were identified, and abstracts were analyzed. Twenty-one relevant studies were then identified and reviewed. After all, information was gathered from 16 studies, the authors discussed the specific topics, and expert opinions were also included in the discussion. There have been some studies that can help us to have some insights on how to manage these patients. Very distinctive strategies have been reported in the literature, mainly anecdotally or in small randomized studies. Some of these treatments outlined in the present manuscript include repeated TURBTs, chemoablation, BCG immunoablation, partial cystectomy, radical cystectomy, radiotherapy, chemotherapy, and future perspectives. In the current manuscript, we have combined these strategies in a proposed algorithm. CONCLUSION: For those LG-NMIBC patients in challenging scenarios, we have found repeated TURBTs, chemoablation, BCG immunoablation, partial cystectomy, radical cystectomy, radiotherapy, and chemotherapy are attractive modalities to treat them effectively. Also, the current manuscript proposes an algorithm to overcome these challenges. Copyright® by the International Brazilian Journal of Urology.
PURPOSE: To describe the current scientific knowledge and clinical experience in low-grade-non-muscle-invasive bladder cancer (LG-NMIBC) patients in challenging scenarios. MATERIALS AND METHODS: Medline, Embase, Google Scholar, and Cochrane Central were searched until March 2021. RESULTS: A total of 841 studies were identified, and abstracts were analyzed. Twenty-one relevant studies were then identified and reviewed. After all, information was gathered from 16 studies, the authors discussed the specific topics, and expert opinions were also included in the discussion. There have been some studies that can help us to have some insights on how to manage these patients. Very distinctive strategies have been reported in the literature, mainly anecdotally or in small randomized studies. Some of these treatments outlined in the present manuscript include repeated TURBTs, chemoablation, BCG immunoablation, partial cystectomy, radical cystectomy, radiotherapy, chemotherapy, and future perspectives. In the current manuscript, we have combined these strategies in a proposed algorithm. CONCLUSION: For those LG-NMIBC patients in challenging scenarios, we have found repeated TURBTs, chemoablation, BCG immunoablation, partial cystectomy, radical cystectomy, radiotherapy, and chemotherapy are attractive modalities to treat them effectively. Also, the current manuscript proposes an algorithm to overcome these challenges. Copyright® by the International Brazilian Journal of Urology.
Entities:
Keywords:
Carcinoma, Transitional Cell; Review Literature as Topic; Urinary Bladder Neoplasms
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