All relevant published case reports of mNMIBC over the years were explicitly summarized for this review to demonstrate the variable clinical presentation of this entity.
Various etiological factors that are possibly related are discussed, including understaging of T1 high-grade disease, repeat transurethral resection of bladder tumors (TURBTs), circulating tumor cells, usage of blue light instead of white light cystoscopies, gender-associated differences, delays in performing radical cystectomy and inability to diagnose molecular and genetic features associated with metastatic disease.
To avoid misdiagnosing this, emphasis should be placed on restaging multiparametric TURBT procedures and considering the utilization of advanced imaging modalities such as MRI and photodynamic diagnosis. These strategies have been shown to help guide treatment decisions and monitor disease progression.
In conclusion, this review addresses the importance of prevention and future directions in managing mNMIBC. It underscores the need for ongoing research to better understand the disease and identify relevant biomarkers for predicting progression from non-muscle-invasive bladder cancer to mNMIBC. This forward-looking approach aims to enhance patient outcomes and refine treatment protocols.
Written by: Hanan Goldberg, MD, MSc1,2
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY, USA
- Upstate Urology at Mohawk Valley Health System (MVHS), Utica, NY, USA