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Clinical Scenario: Initial High-Grade Ta Tumor

45-Year-old healthy man with his first large, high-grade Ta cancer
  • José L. Domínguez-EscrigEmail author
  • Eduardo Solsona Narbón
Chapter

Abstract

With a worldwide incidence rate of 9 per 100,000 for men and 2 per 100,000 for women, bladder cancer is the most common malignancy of the urinary tract, representing the 7th and 17th most frequent malignancy in men and women.

At presentation, 75–85 % of cases are confined to the mucosa or sub-mucosa, being grouped as non-muscle-invasive bladder cancer (NMIBC). However, this is a very lose heading as evidenced at a molecular level and by the very different clinical behavior among these tumors. Regarding pTa G3 disease, the evidence for clinical management, often extrapolated from pT1 high-grade disease, remains limited.

In this clinical scenario, we present a case of a 45-year-old male with a high-grade (G3) pTa urothelial carcinoma of the urinary bladder. We review the logic diagnostic approach, the importance of an accurate staging, as well as, the currently available diagnostic tools. In particular, we review the role of Re-TUR, novel endoscopic aids, and urine tumor markers. Finally, we focus on the role of BCG therapy for these patients.

Keywords

Urothelial carcinoma pTa G3 NMIBC RE-TUR Urine markers and BCG 

Abbreviations

5-ALA

5-Aminolevulinic acid

AUA

American Urology Association

BCG

Bacillus Calmette-Guerin

Cis

Carcinoma in situ

CUETO

Club Urológico Español de Tratamiento Oncológico

EAU

European Association of Urology

HAL

Hexaminolevulinic acid

IBCG

International Bladder Cancer Group

MMC

Mytomicin C

NBI

Narrow band imaging

NICE

National Institute of Clinical Excellence

PDD

Photodynamic diagnosis

PFS

Progression-free survival

RFS

Recurrence-free survival

RE-TUR

Re trans-urethral resection

TUR

Trans-urethral resection

WLC

White light cystoscopy

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • José L. Domínguez-Escrig
    • 1
    Email author
  • Eduardo Solsona Narbón
    • 1
  1. 1.Servicio de UrologíaFundacion Instituto Valenciano de OncologiaValenciaSpain

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