AS aims to achieve de-intensification treatment without compromising oncological outcomes. However, the use of AS for BC remains controversial and debated. BC presents predominantly as non-muscle-invasive tumors, with low-grade tumors having a favorable prognosis but a high recurrence rate. The gold standard treatment for low-grade recurred tumors is transurethral resection of bladder tumor (TURBT), which can be associated with complications and high treatment costs. Alternative approaches like office fulguration and chemoresection have shown promise.
Despite the favorable results, studies on AS for bladder cancer lack consistency and homogeneity, making it difficult to draw definitive conclusions. Proper patient selection, follow-up schedule, and indication for delayed treatment are critical factors for the success of AS in bladder cancer. Standardized inclusion criteria, follow-up schedules, and randomized clinical trials are needed to establish the effectiveness and safety of AS compared to other treatment options.
Our study highlights the potential of AS as a management strategy for recurrent LG NMIBC.1 We sought to provide easy-to-use clinical guidance for urologists on how to safely and effectively use AS in daily clinical practice.
AS offers an alternative to immediate invasive treatments, providing benefits such as reduced resource consumption, decreased risk of complications, and improved patient quality of life. However, the article acknowledges the existing controversies and debates surrounding the use of AS for BC. The lack of consistency and homogeneity among studies on AS makes it challenging to draw definitive conclusions. Therefore, further research, including randomized clinical trials, is necessary to compare oncologic outcomes and quality of life measures between AS and other treatment options. Additionally, the article emphasizes the importance of proper patient selection, standardized inclusion criteria, and follow-up schedules to ensure the safety and effectiveness of AS. A consensus statement among the urologic community would significantly contribute to establishing guidelines for AS in bladder cancer. Overall, AS is a promising approach, but more research is needed to provide conclusive evidence and establish best practices.
Written by: Roberto Contieri1,2 Massimo Lazzeri2 Rodolfo Hurle2
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
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