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SIU-WJU Article of the Month – September 2018
Consensus recommendations for nonmuscle-invasive bladder cancer: applicable to diverse healthcare environments
SIU Academy®. Dr. Manish I. Patel & Dr. Badrinath R. Konety . Sep 1, 2018; 232171
Dr. Manish I. Patel & Dr. Badrinath R. Konety
 Dr. Manish I. Patel & Dr. Badrinath R. Konety
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Abstract
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Purpose

To provide a summary of the Third International Consultation on Bladder Cancer recommendations for the man-agement of non-muscle invasive bladder cancer (NMIBC).

Methods

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.

Results

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.

Conclusions

NMIBC remains a common and challenging malignancy to manage. Accurate staging, grading, and risk strati-fication 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.

Keywords

Bladder cancer | Non-muscle invasive bladder cancer | Transurethral resection of bladder tumor | Staging | Diagnosis | Treatment | Surveillance | Bacillus Calmette–Guerin | Guidelines | ICUD
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