The Scientific World Journal

The Scientific World Journal / 2006 / Article

Review Article | Open Access

Volume 6 |Article ID 879596 | https://doi.org/10.1100/tsw.2006.403

A.P.M. van der Meijden, "Optimal Treatment for Intermediate- and High-Risk, Nonmuscle-Invasive Bladder Cancer", The Scientific World Journal, vol. 6, Article ID 879596, 6 pages, 2006. https://doi.org/10.1100/tsw.2006.403

Optimal Treatment for Intermediate- and High-Risk, Nonmuscle-Invasive Bladder Cancer

Academic Editor: Ziya Kirkali
Received30 Nov 2005
Revised03 Feb 2006
Accepted16 Feb 2006

Abstract

According to clinical and pathological factors the prognosis of a patient with non-muscle invasive bladder tumors can be assessed. The prognosis is determined by the likelihood of recurrence(30-70%) and/or progression to muscle invasive bladder cancer(1-15%).Trans urethral resection of bladder tumors remains the initial therapy but adjuvant intravesical instillations are necessary.All patients benefit from a single immediate post operative instillation with a chemotherapeutic agent and for low risk tumors this is the optimal therapy.Patients with intermediate and high risk tumors need more intravesical chemo-or immunotherapy. Chemotherapy reduces recurrences but not progression. Intravesical immunotherapy(BCG) prevents or delays progression. Patients at high risk for progression may need upfront cystectomy.


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