Developments and controversies in the management of noninvasive bladder cancer.

Abstract:

PURPOSE OF REVIEW:To summarize recent developments and controversies in the diagnosis and management of nonmuscle invasive bladder cancer (NMIBC). RECENT FINDINGS:The majority of incident bladder cancer diagnoses are noninvasive. The mainstay of diagnosis remains cystoscopy and transurethral resection, with enhanced optical techniques potentially improving detection of nascent disease. Intravesical chemotherapeutic and immunotherapeutic agents reduce the likelihood of recurrence and progression, with novel agents showing promise. The identification of variant histology with aggressive phenotypes permits identification of patients unlikely to respond to intravesical agents, in whom early cystectomy is advocated. Risk stratification of patients with NMIBC continues to improve and should be used to inform surveillance and treatment paradigms. Tobacco cessation may improve disease-specific endpoints and overall mortality. SUMMARY:NMIBC encompasses a variety of tumors with heterogeneous natural histories, making clinical management challenging. Improved detection with novel technologies and optimization of existing treatment modalities hold promise of improving oncologic outcomes in the future.

journal_name

Curr Opin Oncol

authors

Bassett JC,Eifler JB,Resnick MJ,Clark PE

doi

10.1097/CCO.0000000000000067

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

299-304

issue

3

eissn

1040-8746

issn

1531-703X

journal_volume

26

pub_type

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