Follow-up after surgical treatment of bladder cancer: A critical analysis of the literature Journal Article
| Authors: | Soukup, V.; Babjuk, M.; Bellmunt, J.; Dalbagni, G.; Giannarini, G.; Hakenberg, O. W.; Herr, H.; Lechevallier, E.; Ribal, M. J. |
| Article Title: | Follow-up after surgical treatment of bladder cancer: A critical analysis of the literature |
| Abstract: | Context: Follow-up of patients treated for bladder cancer (BCa) is of great importance for both non-muscle-invasive BCa (NMIBC) and muscle-invasive BCa (MIBC) because of the high incidence of recurrence and progression. The schedule and methods of follow-up should reflect the individual clinical situation. Objective: To evaluate the existing evidence for intensity and duration of follow-up recommendations in patients after surgical treatment of BCa. Evidence acquisition: We searched the Medline, Embase, and Cochrane databases for published data on the follow-up of patients with NMIBC and MIBC after radical cystectomy (RC). Evidence synthesis: Follow-up in patients with NMIBC is necessary because of the high probability of tumour recurrence and the risk of progression. Cystoscopy plus cytology are the standard methods for follow-up. Cystoscopy should be done 3 mo after the transurethral resection in every patient, and the frequency after that depends on the individual recurrence/progression risk. Cytology should be used as an adjunctive method to cystoscopy in intermediate- and high-risk patients. None of the currently available urinary markers or imaging methods can substitute for cystoscopy-based follow-up. High-risk NMIBC patients require regular lifelong upper urinary tract monitoring. Follow-up in MIBC is based on the fact that early detection of recurrence after RC allows for timely treatment with the aim of improving outcomes. Patients with extravesical and lymph node-positive disease should have the most intensive follow-up because of the highest recurrence risk. Routine upper urinary tract imaging is advisable for all patients and should continue in the long term. Follow-up also allows for early detection of urinary diversion-related complications, the rate of which increases with time. Conclusions: Follow-up in BCa is necessary for diagnosing recurrence and progression, as well as for evaluating complications after radical treatment. Since randomised studies investigating the most appropriate follow-up schedule are lacking, most recommendations are based on only the retrospective experience. Nonetheless, reasonable recommendations can be made until further prospective randomised studies testing different follow-up schedules have been performed. © 2012 European Association of Urology. |
| Keywords: | treatment outcome; cancer surgery; review; cancer recurrence; cancer growth; cancer risk; cancer patient; recurrence risk; follow up; follow-up studies; lymph node metastasis; cancer diagnosis; sensitivity and specificity; biological markers; neoplasm recurrence, local; recurrence; bladder cancer; nuclear matrix protein 22; urinary bladder neoplasms; biopsy; distant metastasis; high risk patient; fluorescence in situ hybridization; systematic review; early diagnosis; urine incontinence; radical cystectomy; cystectomy; urinary diversion; urinary tract infection; progression; carcinoma; medline; hospital discharge; cyanocobalamin deficiency; cystoscopy; cancer epidemiology; microsatellite marker; cochrane library; transurethral resection; urine retention; follow-up; embase; ureter obstruction; urine cytology; bladder biopsy; diagnostic test accuracy study; urolithiasis; metabolic acidosis; muscle-invasive bladder cancer; non-muscle-invasive bladder cancer; megaloblastic anemia; non muscle invasive bladder cancer |
| Journal Title: | European Urology |
| Volume: | 62 |
| Issue: | 2 |
| ISSN: | 0302-2838 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2012-08-01 |
| Start Page: | 290 |
| End Page: | 302 |
| Language: | English |
| DOI: | 10.1016/j.eururo.2012.05.008 |
| PROVIDER: | scopus |
| PUBMED: | 22609313 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 August 2012" - "CODEN: EUURA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work