Abstract
Purpose
To provide a summary of the Third International Consultation on Bladder Cancer recommendations for the management 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.
Conclusion
NMIBC remains a common and challenging malignancy to manage. Accurate staging, grading, and risk stratification 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.
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LLM: manuscript writing/editing, project development. JAW: manuscript writing/editing. PKA: manuscript writing. CBA: manuscript writing. TJB: manuscript writing. BHB: manuscript writing. JLB: manuscript writing. SSC: manuscript writing. JLD: manuscript writing. JMM: manuscript writing. CD: manuscript writing. GG: manuscript writing. GSK: manuscript writing. PM: manuscript writing. MAO: manuscript writing. CAR: manuscript writing. JBS: manuscript writing. ES: manuscript writing. RSS: manuscript writing. AGH: manuscript writing. FJPV: manuscript writing. WK: manuscript writing/editing, project development
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Author JA Witjes has relationship with Sanofi Pasteur, MEL Amsterdam (Synergo), Cepheid, Nucleix, BMS, Taris, BioCancel and Spectrum. Author SS Chang has relationship with Mdx Health, BioCancel, Bristol Myers Squibb, and Altor. Author GS Kulkarni has received research funds from Biosyent Canada. Author MA O’Donnell has relationship with Abbot Molecular, Roche, Photocure, Urogen, Medical Enterprises, Viventia, Spectrum, Fidia Pharmaceuticals, Vaxiion Pharmaceuticals, and Therlasae. The other authors declare that they have no conflict of interest.
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Monteiro, L.L., Witjes, J.A., Agarwal, P.K. et al. ICUD-SIU International Consultation on Bladder Cancer 2017: management of non-muscle invasive bladder cancer. World J Urol 37, 51–60 (2019). https://doi.org/10.1007/s00345-018-2438-9
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DOI: https://doi.org/10.1007/s00345-018-2438-9