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Current Urology Reports

, 20:79 | Cite as

High-grade T1 Urothelial Carcinoma: Where Do We Stand?

  • Wesley Yip
  • Akbar Ashrafi
  • Siamak DaneshmandEmail author
Urothelial Cancer (S Daneshmand, Section Editor)
  • 53 Downloads
Part of the following topical collections:
  1. Topical Collection on Urothelial Cancer

Abstract

Purpose of Review

Bladder cancer is a deadly and common malignancy, with 24% of new cases presenting as T1 disease. High-grade T1 in particular represents a difficult entity to treat due to its clinical variability and known risks of recurrence, progression, and cancer-specific mortality. The differences in guidelines from major urologic organizations underscore this variability, and the past year has seen another BCG shortage, further complicating management. Advances have been made in the molecular and genomic characterization of high-grade T1, and new clinical trials are available to investigate alternative therapies. In this review, we summarize the variations in guidelines, alternatives to BCG, emerging molecular and genomic discoveries, and recent clinical trials.

Recent Findings

Adherence to guidelines for non-muscle-invasive bladder cancer in the community among practicing urologists remains low, in part due to the variations in available guidelines. In the era of a BCG shortage, decreased dosing schedules and alternative intravesical options are increasingly being used. New biomarkers are being discovered to better risk-stratify patients, with future therapies aimed at targeting aggressive disease.

Summary

HGT1 urothelial carcinoma remains a highly variable and aggressive disease, but we are making significant progress in better characterizing the clinical and molecular factors that influence recurrence and progression, to better guide management.

Keywords

High-grade T1 Bladder cancer BCG 

Notes

Compliance with Ethical Standards

Conflict of Interest

Wesley Yip and Akbar Ashrafi each declare no potential conflicts of interest. Siamak Daneshmand is a section editor for Current Urology Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.USC Institute of Urology/Norris Comprehensive Cancer CenterLos AngelesUSA

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