High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder

Sylvester, Richard; Meijden, A. Van Der; Witjes, J. Alfred; Jakse, G.; Nonomura, Norio; Cheng, Chin-I; Torres, Aaron; Watson, Roger B.; Kurth, K. H.

doi:10.1016/j.urology.2005.06.135

Cited by 188 publications

(129 citation statements)

References 106 publications

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“…When found in isolation or in the presence of Ta/T1 disease, currently recommended strategies subsequent to transurethral resection include intravesical immunotherapy (eg BCG therapy), intravesical chemotherapy (eg epirubicin) or indeed radical cystectomy. 2 Without any treatment, approximately 54% of patients with CIS progress to muscle invasive disease. 3 This highlights the importance of early diagnosis and subsequent ONLINE CASE REPORT treatment.…”

Section: Discussionmentioning

confidence: 99%

Complication of treatment of carcinoma in situ of the bladder with photodynamic targeted cystodiathermy

Murtagh

Kockelbergh

2014

annals

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We report two cases of bladder contracture following photodynamic or 'blue light' detection and cystodiathermy for bladder carcinoma in situ. These patients were unsuitable for treatment with immunotherapy/chemotherapy or had disease recurrence following such treatment. Radical cystectomy was not a treatment option in either patient. Each underwent serial photodynamic cystodiathermy over a three-year period. Neither patient developed muscle invasive disease. However, treatment resulted in contracture of the bladder and incontinence of urine. Patients need to be fully aware of this potential complication in order to make informed choices about their care. Case 1This patient was a 75-year-old man with frank haematuria who was found to have a diagnosis of carcinoma in situ (CIS) on biopsy following suspicious urine cytology. Relevant medical history included idiopathic thrombocytopenia purpura, a prior splenectomy, three previous deep vein thromboses, and an unspecified vasculitis requiring immunosuppression with azathioprine and prednisolone. Intravesical bacillus Calmette-Guérin (BCG) or mitomycin therapies were contraindicated owing to his immunosuppressed status and history of thrombocytopenia. His premorbid state deemed him an unsuitable candidate for a radical cystectomy. Following initial resection, he underwent blue light guided cystodiathermy ablation of fluorescent areas on a six-monthly basis. Between

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Section: Discussionmentioning

confidence: 99%

Complication of treatment of carcinoma in situ of the bladder with photodynamic targeted cystodiathermy

Murtagh

Kockelbergh

2014

annals

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“…They compared BCG with different intravesical chemotherapy regimens. 56 They found a 68% complete response rate with BCG versus a 48% complete response rate with chemotherapy. The overall disease-free rates over a median follow up of 3.75 years were 51% versus 27% for BCG versus chemotherapy respectively.…”

Section: Bcgmentioning

confidence: 98%

Canadian guidelines for treatment of non-muscle invasive bladder cancer: a focus on intravesical therapy

Kassouf

Kamat

Zlotta

et al. 2013

CUAJ

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“…6 Unlike other premalignant 'in situ' conditions, CIS of the bladder is recognised as a high-grade malignancy by definition, because of its high rates of progression and recurrence. 1,2,7,8 In spite of this, CIS of the bladder is not currently considered a reportable malignancy in many countries, including the UK, and is therefore not registered as a malignant condition and not included in the bladder cancer statistics because of its nomenclature. 9 As a result, the incidence of CIS of the bladder in many countries is unknown.…”

Section: Challenges In Identifying the Incidence Of Cismentioning

confidence: 99%

“…1 This can occur in isolation in the bladder urothelium with no previous or concurrent papillary tumours (primary), during the follow-up of patients with a previous papillary tumour (secondary) or in the presence of papillary tumours (concurrent). [2][3][4] The diagnosis of CIS of the bladder can be challenging because of the non-specific nature of presentation (Box 1). Although Bacille Calmette-Guérin (BCG) therapy is shown to be effective against primary CIS, a significant proportion of patients still progress to muscle-invasive disease.…”

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confidence: 99%