The management of superficial bladder cancer Journal Article
| Author: | Dalbagni, G. |
| Article Title: | The management of superficial bladder cancer |
| Abstract: | From review of the currently available trial evidence, several clinical recommendations for bladder tumor management become apparent. Transurethral resection should be done, but this procedure is prone to both overestimating and underestimating staging. Restaging transurethral resection for patients with T1 tumors should, therefore, be performed. Data support the immediate postoperative instillation of a chemotherapeutic agent for patients with solitary, low-grade papillary tumors, whereas patients with multiple lesions might benefit from a more intensive adjuvant regimen. Although the use of intravesical immunotherapy for reducing tumor progression or as maintenance therapy is controversial, bacillus Calmette-Guérin has demonstrated significant benefit for tumor prophylaxis when no obvious residual disease is present. Early radical cystectomy can be beneficial and should be performed in patients with refractory T1 tumors or carcinoma in situ before progression to muscle invasion. In this Review I present an overview of the management of nonmuscle invasive bladder cancer. The most common intravesical chemotherapeutic agents are described as well as the impact of chemotherapy on the recurrence and progression of tumors. The effect of intravesical immunotherapy in bladder cancer is explored as well as the role of early cystectomy. |
| Keywords: | cancer chemotherapy; treatment outcome; survival analysis; clinical trial; histopathology; review; cytotoxic agent; doxorubicin; drug dose comparison; side effect; unspecified side effect; gemcitabine; adjuvant therapy; postoperative care; cancer staging; recurrent cancer; antineoplastic agent; cancer diagnosis; neoplasm staging; cancer grading; diagnostic accuracy; evidence based medicine; treatment indication; alpha2b interferon; bcg vaccine; cancer immunotherapy; multiple cycle treatment; neoplasm recurrence, local; antineoplastic combined chemotherapy protocols; bladder cancer; urinary bladder neoplasms; hematuria; thiotepa; risk assessment; drug fever; drug hypersensitivity; cancer inhibition; immunotherapy; drug accumulation; drug uptake; randomized controlled trials; systematic review; dosage schedule comparison; cystectomy; urinary frequency; epirubicin; mitomycin c; cystoscopy; drug absorption; drug blood level; transurethral resection; carcinoma, transitional cell; cystitis; administration, intravesical; bladder carcinoma; anthracycline; drug treatment failure; transitional cell carcinoma; meta analysis; valrubicin; dysuria; maintenance drug dose; early intervention; bladder biopsy; systemic disease; bladder capacity; chemical cystitis |
| Journal Title: | Nature Clinical Practice Urology |
| Volume: | 4 |
| Issue: | 5 |
| ISSN: | 1743-4270 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2007-05-01 |
| Start Page: | 254 |
| End Page: | 260 |
| Language: | English |
| DOI: | 10.1038/ncpuro0784 |
| PUBMED: | 17483810 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 35" - "Export Date: 17 November 2011" - "Source: Scopus" |
