Active surveillance for low-risk bladder cancer

Abstract Background Most newly diagnosed bladder cancers present as non–muscle invasive bladder cancer (NMIBC). NMIBC is a heterogeneous disease with varying treatment options, follow-up schedules, and oncologic outcomes. We sought to review the role of active surveillance for low risk bladder cance...

Full description

Saved in:
Bibliographic Details
Published in:Urologic oncology 2014, Vol.32 (1), p.33.e7-33.e10
Main Authors: Tiu, Albert, M.B.B.S, Jenkins, Lawrence C., M.D, Soloway, Mark S., M.D
Format: Article
Language:English
Subjects:
Active surveillance
Bladder cancer
Cost
Cystoscopy
Disease Progression
Humans
Low risk
Medical Oncology - methods
Neoplasm Recurrence, Local - diagnosis
Neoplasm Recurrence, Local - pathology
Quality of Life
Risk
Transurethral resection of bladder tumor
Treatment Outcome
Urinary Bladder Neoplasms - diagnosis
Urinary Bladder Neoplasms - epidemiology
Urinary Bladder Neoplasms - surgery
Urology
Urology - methods
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Most newly diagnosed bladder cancers present as non–muscle invasive bladder cancer (NMIBC). NMIBC is a heterogeneous disease with varying treatment options, follow-up schedules, and oncologic outcomes. We sought to review the role of active surveillance for low risk bladder cancer in the literature. Methods A PubMed search was performed using the following keywords: active surveillance, low risk, bladder, transurethral resection of bladder tumor, cost, and quality of life. Relevant articles were reviewed and utilized. Results Low-risk bladder cancer—defined as pTa low-grade papillary tumors—is the type of NMIBC with the most favorable oncologic outcome and which almost never progresses to muscle invasive disease or metastasizes. Bladder cancer has the highest per patient treatment costs of all cancers. One of the reasons is the high rate of recurrence. Patients with low-grade bladder tumors often experience a recurrence after primary transurethral resection. Many patients undergo multiple resections in the hospital. Conclusions Appropriately selected patients with recurrent low-risk bladder cancer could be managed with either office fulguration or cystoscopic surveillance. Active surveillance for patients with low-risk bladder cancer avoids or delays the surgical and anesthetic risks of a TURBT, thus optimizing quality of life without compromising the patient's risk of cancer progression.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2012.12.003