European Association of Urology Guidelines on Non–muscle-invasive Bladder Cancer (Ta, T1, and Carcinoma in Situ)

EAU Guidelines on Non–Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016

European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and Carcinoma In Situ) - 2019 Update

EAU Guidelines on Non–Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2013

EAU Guidelines on Non–Muscle-Invasive Urothelial Carcinoma of the Bladder, the 2011 Update

EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2011 update

Guía clínica del carcinoma urotelial de vejiga no músculo-invasivo de la Asociación Europea de Urología. Actualización de 2011

Real-World Outcomes Driving the Needle toward Simplification of Nonmuscle Invasive Bladder Cancer Risk Stratification.

Photodynamic Diagnosis in Non–Muscle-Invasive Bladder Cancer

About 70% of bladder cancers (BCs) are diagnosed as non-muscle-invasive BCs (NMIBCs), while the remaining are muscle-invasive BCs (MIBCs). The European Association of Urology (EAU) guidelines stratify NMIBCs into low, intermediate, and high risk for treatment options. Low-risk NMIBCs undergo only the transurethral resection of the bladder (TURB), whereas for intermediate-risk and high-risk NMIBCs, the transurethral resection of the bladder (TURB) with or without Bacillus Calmette-Guérin (BCG) immune or chemotherapy is the standard treatment. A minority of NMIBCs show unfavorable prognosis. High-risk NMIBCs have a high rate of disease recurrence and/or progression to muscle-invasive tumor and BCG treatment failure. The heterogeneous nature of NMIBCs poses challenges for clinical decision-making. In 2020, the EAU made some changes to NMIBCs BCG failure definitions and treatment options, highlighting the need for reliable molecular markers for improving the predictive accuracy of currently available risk tables. Nowadays, next-generation sequencing (NGS) has revolutionized the study of cancer biology, providing diagnostic, prognostic, and therapy response biomarkers in support of precision medicine. Integration of NGS with other cutting-edge technologies might help to decipher also bladder tumor surrounding aspects such as immune system, stromal component, microbiome, and urobiome; altogether, this might impact the clinical outcomes of NMBICs especially in the BCG responsiveness. This review focuses on NMIBCs with unfavorable prognoses, providing molecular prognostic factors from tumor immune and stromal cells, and the perspective of urobiome and microbiome profiling on therapy response. We provide information on the cornerstone of immunotherapy and new promising bladder-preserving treatments and ongoing clinical trials for BCG–unresponsive NMIBCs.

Assessment of diagnostic gain with hexaminolevulinate (HAL) in the setting of newly diagnosed non–muscle-invasive bladder cancer with positive results on urine cytology

Risk stratification of Ta high-grade non-muscle-invasive bladder cancer: Insights from a multicenter cohort study.

EORTC Nomograms and Risk Groups for Predicting Recurrence, Progression, and Disease-specific and Overall Survival in Non–Muscle-invasive Stage Ta–T1 Urothelial Bladder Cancer Patients Treated with 1–3 Years of Maintenance Bacillus Calmette-Guérin

To investigate whether department-level use of photodynamic diagnosis (PDD) for primary transurethral bladder resections (TURBs) is associated with recurrence and progression rates in a non-selected, national cohort. Non-muscle invasive bladder cancer (NMIBC) has high global prevalence, and is characterized by high recurrence risk and risk of progression to muscle-invasive bladder cancer. Treatment effects and long-term outcomes rely on diagnostic accuracy, which may be enhanced using PDD for TURB. PDD-use in Denmark has varied between departments. Material and Methods: We identified all Danish patients with primary NMIBC during 2011-2017 via the Danish National Patient Registry (DNPR) and divided them into four groups based on the treating department's annual PDD use. We included 8,502 patients; 76% men, median age at diagnosis: 70 years (interquartile range [IQR]: 63, 77). Primary outcomes were recurrence- and progression risk differences (RDs) at 2 and 5 years depending on the PDD-exposure group. Results were additionally stratified by baseline pathological risk group. The PDD-use varied from <40% of primary TURBs in group 1 to >74% in group 4. Overall 2- and 5 years recurrence risks were 39.9% [95% CI: 38.8; 41.0] and 48.1% [95% CI: 46.9; 49.3], while risks of progression were 17.5% [95% CI: 16.7; 18.4] and 22.9% [95% CI: 21.9; 23.9]. PDD-exposure groups 2-4 had lower recurrence- and progression risks compared to group 1, most pronounced for high-risk NMIBC. PDD-use in primary TURBs correlates with reduced 2- and 5 years recurrence- and progression risks in NMIBC. The PDD benefit was most noticeable in higher risk NMIBC. Photodynamic diagnosis, primary Trans Urethral Resection of the Bladder (TURB), progression risk, recurrence risk.

MAINTENANCE BACILLUS CALMETTE-GUERIN IMMUNOTHERAPY FOR RECURRENT TA, T1 AND CARCINOMA IN SITU TRANSITIONAL CELL CARCINOMA OF THE BLADDER: A RANDOMIZED SOUTHWEST ONCOLOGY GROUP STUDY

1757 CYTOKERATIN 18 AND EAU SCORE PREDICT TUMOR RECURRENCE IN PATIENTS WITH NON-MUSCLE-INVASIVE BLADDER CANCER FOLLOWING SINGLE POSTOPERATIVE IMMEDIATE INTRAVESICAL CHEMOTHERAPY INSTILLATION