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Treatment of low-risk non-muscle-invasive bladder cancer

Publication at Second Faculty of Medicine |
2012

Abstract

Low-risk non-muscle-invasive bladder cancer (NMIBC) accounts for approximately 50 % of newly diagnosed bladder cancer. It is defined by the European Organisation for Research and Treatment of Cancer (EORTC) risk tables and is characterised by low risk of both recurrence and progression.

Transurethral resection of the bladder (TURB) is the crucial step in its management. The aim is to eradicate all tumours and establish an accurate diagnosis.

Narrow-band imaging and fluorescence cystoscopy (photodynamic diagnosis [PDD]) detect more lesions. PDD also improves recurrence-free survival.

Single immediate intravesical instillation after TURB is the standard of care in low-risk NMIBC since it prolongs time to recurrence. Some patients with small papillary recurrent low risk tumours may be observed or treated by office fulguration.

All patients should be followed by regular cystoscopies. Results of the first cystoscopy three months after TURB is a surrogate marker for patient's prognosis