A risk-stratified approach to the management of high-grade T1 bladder cancer

Current Opinion in Urology
Miles P MannasPeter C Black

Abstract

A bladder-preserving approach for high-grade nonmuscle invasive bladder cancer that has invaded the lamina propria (T1HG) may result in increased recurrence, progression, and even death from bladder cancer in some patients. Initial radical cystectomy does have increased cancer-specific survival (CSS), but represents significant overtreatment for many patients. An evidence-based, risk-stratified approach is required to select patients for immediate radical cystectomy in order to improve CSS. A restaging transurethral resection aids in optimal staging and treatment of T1HG. Intravesical Bacillus Calmette-Guerin induction followed by 3 years of maintenance is the standard adjuvant management. However, when very high-risk (hydronephrosis, abnormal bimanual examination, variant histology, lymphovascular invasion, or residual disease on re-resection, and Bacillus Calmette-Guerin failure or early recurrence) or multiple high-risk factors (concomitant CIS, size >3 cm, multifocality, unfavorable tumor location, extensive lamina propria invasion, and elderly) are present, the risk of progression often outweighs the risk associated with radical cystectomy. In these cases, an immediate radical cystectomy likely provides an improved opportu...Continue Reading

References

Jan 10, 2006·Urology·Alan M NiederMichael A S Jewett
Mar 29, 2006·BJU International·Harry W Herr, S Machele Donat
Oct 24, 2007·European Urology·Jesus Fernandez-GomezUNKNOWN Club Urológico Español de Tratamiento Oncológico (CUETO)
Mar 1, 2008·Urology·Amit GuptaUNKNOWN Bladder Cancer Research Consortium
Jan 20, 2010·The Journal of Urology·Martine PloegLambertus A Kiemeney
May 11, 2010·Urologic Oncology·Jeffrey S MontgomeryJames E Montie
Feb 8, 2011·TheScientificWorldJournal·Harry W Herr
Apr 8, 2011·Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada·Venu ChalasaniJonathan I Izawa
Nov 1, 2011·European Urology·Bas W G van RhijnAlexandre R Zlotta
Jan 2, 2013·Clinical Genitourinary Cancer·Julien BranchereauJérôme Rigaud
Aug 6, 2013·The Journal of Urology·Stephen H CulpColin P N Dinney
Jan 7, 2014·European Urology·Atiqullah AzizUNKNOWN PROMETRICS 2011 research group
Mar 8, 2014·The Journal of Urology·Massimiliano SpalivieroHarry W Herr
Sep 26, 2014·The Journal of Urology·Daniel L WillisAshish M Kamat
Jan 7, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·William Martin-DoyleJoaquim Bellmunt
Apr 14, 2016·Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica·Daniele MinardiGiovanni Muzzonigro
May 22, 2016·BJU International·David M GolombosDouglas S Scherr
Jun 19, 2016·The Journal of Urology·Sam S ChangJames M McKiernan
Jun 22, 2016·European Urology·Marko BabjukRichard Zigeuner
Jul 20, 2016·Nature Reviews. Urology·Romain MathieuShahrokh F Shariat
Aug 29, 2017·Clinical Genitourinary Cancer·William P ParkerStephen A Boorjian
Jun 9, 2018·Urologic Oncology·Elisabeth E Fransen van de PutteBas W G van Rhijn

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Citations

Feb 6, 2022·Virchows Archiv : an International Journal of Pathology·Antonio Lopez-BeltranLiang Cheng

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