Abstract

Non–muscle-invasive bladder cancer (NMIBC) makes up 75% of the fifth most common cancer in North America. With a high rate of recurrence and progression, which leads to significant treatment burden for patients and high costs to healthcare systems, NMIBC poses several critical clinical challenges. Enhanced cystoscopic techniques are improving detection and optimal resection of these tumors. The administration of intravesical therapies, including especially cytotoxic chemotherapy and bacillus Calmette-Guérin (BCG) therapy, continues to evolve, and several promising agents are under development. Refined definitions of treatment failure are promoting clinical trial activity in this domain. The optimal timing of radical cystectomy for BCG therapy–unresponsive patients continues to be a key unresolved question, but advances in the molecular characterization of NMIBC are likely to enhance individualized, risk-adapted therapy in the near future. This review contains 3 Figures, 10 Tables and 91 references Key words: bladder cancer; cystoscopy; narrow band imaging; fluorescence cystoscopy; transurethral resection of bladder tumor (TURBT); intravesical chemotherapy; bacillus Calmette-Guérin (BCG) therapy; urine markers.

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