What is New in Bladder Cancer Diagnosis and Management?

Abstract

Objectives This paper discusses the most relevant new findings on bladder cancer (BCa) presented at the 2007 annual meetings of the European Association of Urology (EAU), American Urological Association (AUA), and American Society of Clinical Oncology (ASCO). Methods The most relevant abstracts on BCa were selected by urological experts in the field of BCa, who are members of the Oncoforum group, and presented during the Oncoforum summary meeting in Brussels, Belgium. The abstracts were selected based on the following criteria: innovative data, relevance to clinical practice, and robust methodology (eg, multicentre trial, randomised, number of patients). Results Major topics were the use of apoptotic biomarkers to enhance the diagnostic performance and the failure of 5-aminolevunilic acid-induced fluorescence cystoscopy to improve recurrence-free survival rates in patients with non–muscle-invasive disease. Regarding the management of non–muscle-invasive BCa, the efficacy of a maintenance adjuvant instillation therapy was demonstrated. Other studies showed that ofloxacin prophylaxis reduced the bacillus Calmette-Guérin (BCG)-induced side-effects and suggested a survival benefit with adjuvant BCG therapy among older patients. For patients with low-grade upper urinary tract transitional cell carcinoma (TCC), endoscopic treatment seems to be effective and safe, whereas for patients with high-grade upper urinary tract TCC, a laparoscopic nephroureterectomy might be a valid treatment option. Finally, laparoscopic radical cystectomy seems to offer potential for the treatment of patients with infiltrative/advanced BCa. Two studies suggested that in addition to a cystectomy, patients may benefit from a more extensive lymphadenectomy. Conclusions New data presented at these meetings might contribute to an improved management of BCa.