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Clinical Scenario: Low-Grade T1 Tumor

A 72-Year-old woman with a 3 cm low-grade T1 tumor located in the bladder dome and without muscle present in the resected specimen

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Management of Bladder Cancer

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Abstract

In this chapter, we present our view on the diagnosis and treatment of a 72-year-old woman with a 3 cm low-grade T1 tumor located in the bladder dome and without muscle present in the resected specimen. Some factors would suggest a good prognosis; some suggest a high risk for recurrence and progression. We discuss age, gender, and tumor size (or, as a possible surrogate, tumor weight) as prognostic factors. Furthermore, variability in grading and staging and the diagnosis of low-grade T1 are addressed. Tumor location as a prognostic factor and the prognostic importance and technical aspects of the tumor resection are discussed. In light of a complete resection, re-resection, random biopsies and the value of fluorescence cystoscopy are reviewed and commented. Finally, we review additional therapies such as intravesical chemotherapy, BCG, and radical surgery in different clinical scenarios.

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Abbreviations

5-ALA:

5-Aminolevulinic acid

AUA:

American Association of Urology

BCG:

Bacillus Calmette-Guérin

CIS:

Carcinoma in situ

EAU:

European Association of Urology

EORTC:

European Organization for Research and Treatment of Cancer

FC:

Fluorescence cystoscopy

HG:

High grade

MMC:

Mitomycin C

NMIBC:

Non-muscle-invasive bladder cancer

SPI:

Single postoperative instillation

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Authors and Affiliations

  1. Department of Urology, Radboud University Nijmegen Medical Centre, 9101, Nijmegen, HB, 6500, The Netherlands

    J. Alfred Witjes M.D., Ph.D. & Florine W. M. Schlatmann M.D.

Authors
  1. J. Alfred Witjes M.D., Ph.D.
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  2. Florine W. M. Schlatmann M.D.
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Corresponding author

Correspondence to J. Alfred Witjes M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA

    Badrinath R. Konety

  2. Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Sam S. Chang

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Witjes, J.A., Schlatmann, F.W.M. (2015). Clinical Scenario: Low-Grade T1 Tumor. In: Konety, B., Chang, S. (eds) Management of Bladder Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1881-2_17

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  • DOI: https://doi.org/10.1007/978-1-4939-1881-2_17

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  • Online ISBN: 978-1-4939-1881-2

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