To provide a summary of the Third International Consultation on Bladder Cancer recommendations for the management of non-muscle invasive bladder cancer (NMIBC).
A detailed review of the literature was performed focusing on original articles for the management of NMIBC. An international committee assessed and graded the articles based on the Oxford Centre for Evidence-based Medicine system. The entire spectrum of NMIBC was covered such as prognostic factors of recurrence and progression, risk stratification, staging, management of positive urine cytology with negative white light cystoscopy, indications of bladder and prostatic urethral biopsies, management of Ta low grade (LG) and high risk tumors (Ta high grade [HG], T1, carcinoma in situ [CIS]), impact of BCG strain and host on outcomes, management of complications of intravesical therapy, role of alternative therapies, indications for early cystectomy, surveillance strategies, and new treatments. The working group provides several recommendations on the management of NMIBC.
Recommendations were summarized with regard to staging; management of primary and recurrent LG Ta and high risk disease, positive urine cytology with negative white light cystoscopy and prostatic urethral involvement; indications for timely cystectomy; and surveillance strategies.
NMIBC remains a common and challenging malignancy to manage. Accurate staging, grading, and risk stratification are critical determinants of the management and outcomes of these patients. Current tools for risk stratification are limited but informative, and should be used in clinical practice when determining diagnosis, surveillance, and treatment of NMIBC.
World journal of urology. 2018 Aug 14 [Epub ahead of print]
Leonardo L Monteiro, J Alfred Witjes, Piyush K Agarwal, Christopher B Anderson, Trinity J Bivalacqua, Bernard H Bochner, Joost L Boormans, Sam S Chang, Jose L Domínguez-Escrig, James M McKiernan, Colin Dinney, Guilherme Godoy, Girish S Kulkarni, Paramananthan Mariappan, Michael A O'Donnell, Cyrill A Rentsch, Jay B Shah, Eduardo Solsona, Robert S Svatek, Antoine G van der Heijden, F Johannes P van Valenberg, Wassim Kassouf
Division of Urology, McGill University Health Center-Glen Site, 1001 Decarie Blvd, Montreal, QC, H3A 3J1, Canada., Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands., Urologic Oncology Branch, National Cancer Institute, Bethesda, MD, USA., Department of Urology, Columbia University, New York, USA., The James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA., Urology Service, Department of Surgery, Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, USA., Department of Urology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Ingram Cancer Center, Vanderbilt University, Tennessee, USA., Department of Urology, Instituto Valenciano de Oncología, Valencia, Spain., Department of Urology, MD Anderson Cancer Center, Houston, USA., Scott Department of Urology, Baylor College of Medicine, Houston, USA., Division of Urology, Department of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada., Department of Urology, Western General Hospital, University of Edinburgh, Edinburgh, UK., University of Iowa, Iowa City, USA., Department of Urology, University of Basel, Basel, Switzerland., Department of Urology, Stanford University School of Medicine, Stanford, USA., Department of Urology, Division of Urologic Oncology, The University of Texas Health San Antonio, San Antonio, USA., Division of Urology, McGill University Health Center-Glen Site, 1001 Decarie Blvd, Montreal, QC, H3A 3J1, Canada. .