There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
To present the updated version of 2008 European Association of Urology (EAU) guidelines
on non-muscle-invasive bladder cancer.
A systematic review of the recent literature on the diagnosis and treatment of non-muscle-invasive
bladder cancer was performed. The guidelines were updated and the level of evidence
and grade of recommendation were assigned.
The diagnosis of bladder cancer depends on cystoscopy and histologic evaluation of
the resected tissue. A complete and correct transurethral resection (TUR) is essential
for the prognosis of the patient. When the initial resection is incomplete or when
a high-grade or T1 tumour is detected, a second TUR within 2-6 wk should be performed.
The short- and long-term risks of both recurrence and progression may be estimated
for individual patients using the scoring system and risk tables. The stratification
of patients to low, intermediate, and high-risk groups-separately for recurrence and
progression-represents the cornerstone for indication of adjuvant treatment. In patients
at low risk of tumour recurrence and progression, one immediate instillation of chemotherapy
is strongly recommended. In those at an intermediate or high risk of recurrence and
an intermediate risk of progression, one immediate instillation of chemotherapy should
be followed by further instillations of chemotherapy or a minimum of 1 yr of bacillus
Calmette-Guerin (BCG). In patients at high risk of tumour progression, after an immediate
instillation of chemotherapy, intravesical BCG for at least 1 yr is indicated. Immediate
cystectomy may be offered to the highest risk patients and in patients with BCG failure.
The long version of the guidelines is available on www.uroweb.org.
These EAU guidelines present the updated information about the diagnosis and treatment
of non-muscle-invasive bladder cancer and offer the recent findings for the routine
clinical application.