Safety of Active Surveillance Program for Recurrent Nonmuscle-invasive Bladder Carcinoma

Hernández, Virginia; Álvarez, Mónica; Peña, Enrique de la; Amaruch, N.; Martín, M.D.; Morena, J.M. De La; Gómez, Victoria; Llorente, C.

doi:10.1016/j.urology.2008.12.061

Cited by 34 publications

(19 citation statements)

References 16 publications

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“…[3] Individualized management for each patient, predicting the risk of recurrence and progression in NIMBC is a crucial point. For example, fulguration, [4] adjuvant chemotherapy, [5] or active surveillance alone [6] could be adequate treatment modalities for patients with low potential of recurrence and progression. Controlled, prospective, randomized multicenter studies are required for the selection of appropriate treatment modality.…”

Section: Discussionmentioning

confidence: 99%

Applicability of the EORTC risk tables to predict outcomes in non-muscle-invasive bladder cancer in Turkish patients

Kılınç¹,

Bayar²,

Dalkılıç³

et al. 2017

Turkish Journal of Urology

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Objective: To evaluate the consistency of the results of patients who were treated for non-muscle-invasive bladder cancer (NMIBC) in our clinic with the European Organization for Research and Treatment of Cancer (EORTC) risk table.Material and methods: Data were retrospectively analyzed from 452 patients who had undergone transurethral resection of bladder tumor (TUR-BT) between the years 2002, and 2010 for primary or recurrent NMIBC. Our study had a retrospective design but based on prospective cohort study. Patients were staged according to the 2002 Tumor Node Metastasis (TNM) classification and the 1973 World Health Organization grading system. Recurrence was defined as non-muscle-invasive or muscle-invasive and progression as muscle-invasive tumor determined based on following cystoscopy and TUR-BT results, and confirmed by histopathologic analysis. Patients in the current study were classified into four groups according to the EORTC risk tables. Time to first recurrence and progression was determined for each risk group. Results:Of the 452 patients, 348 were enrolled in this study. The overall mean follow-up period was 55.25 months of all patients. Of 348 patients, 130 (37.4%) and 258 patients (74.1%) had recurrence after treatment at the 1 and 5 year follow-up period, respectively. While 35 (10.1%) and 99 patients (28.4%) progressed to muscle-invasive cancer at the 1 and 5 year follow-up period, respectively. In the multivariate analysis, grade, number, size of the tumor size, and concomitant carcinoma in situ were found to be statistically significant for disease progression and recurrence. Conclusion:When EORTC risk tables were comparatively evaluated in our patient population, we can say that EORTC tables predict nearly accurately the clinical course of patients with NMIBC.

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Section: Discussionmentioning

confidence: 99%

Applicability of the EORTC risk tables to predict outcomes in non-muscle-invasive bladder cancer in Turkish patients

Kılınç¹,

Bayar²,

Dalkılıç³

et al. 2017

Turkish Journal of Urology

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“…Several studies have used conservative management with observation in patients with low grade Ta disease [18,19,20]. [21].…”

Section: Discussionmentioning

confidence: 99%

The Role of Photodocumentation in Surveillance Cystoscopy for Bladder Cancer

Reid¹,

Djaladat²,

Daneshmand³

2011

UIJ

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PURPOSE:To determine if the combination of photodocumentation and electronic medical record keeping led to changes in the management of suspicious lesions in patients with bladder cancer undergoing surveillance cystoscopy. METHODS:We reviewed the charts of all patients undergoing surveillance cystoscopy for bladder cancer during a 15-month period. We evaluated patients who had photodocumentation of bladder lesions in our electronic medical record (EPIC). Baseline demographics, surveillance data, and biopsy results were collected, and the outcome of photodocumentation was analyzed. A cost base analysis was performed using figures obtained from the billing department. RESULTS:During the study period, 50 patients underwent flexible cystoscopy for bladder cancer surveillance at our institution. Fifteen were identified who met the study criteria. Using photodocumentation in EPIC, nine patients had well-documented lesions that had no change during the surveillance period with negative urine cytology and therefore did not undergo biopsy. Six patients, however, did undergo biopsy based on a change in the appearance of the lesion. Biopsies demonstrated 3 benign lesions, 2 low-grade transitional cell carcinomas, and 1 muscle-invasive lesion. An economic base analysis demonstrated a cost reduction of 27% and 55% compared with office-based biopsy and transurethral resection of bladder tumor, respectively, by using photodocumentation. CONCLUSIONS: Photodocumentation of lesions during flexible cystoscopy is a useful tool in bladder cancersurveillance. It provides support for clinical decisions and is a cost-effective way to monitor patients undergoing frequent interventions.

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“…In a separate analysis of 22 patients managed expectantly, only 2 patients (9%) had evidence of progression after an average of 17 months [51]. Furthermore, Hernandez et al reported the successful observation of 64 patients with NMIBC for an average of 10.3 months and, while no patient progressed to muscle invasive disease, 6.5% of patients progressed to a higher stage and 16.2% to a higher grade [52]. Compared to historical controls matched for clinical characteristics, the authors found no significant differences in progression rates.…”

Section: Intravesical Therapymentioning

confidence: 99%

Natural biology and management of nonmuscle invasive bladder cancer

Scarpato

Tyson²,

Clark³

2016

Current Opinion in Oncology

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Purpose of review To review the natural biology of non-invasive bladder cancer and its management strategies while summarizing the most recent advances in the field. Recent findings Non-muscle invasive bladder cancer (NMIBC) has a tendency to recur and progress. Risk stratification has helped triage patients but improved tools, including biomarkers, are still needed. Enhanced endoscopy with photodynamic imaging, narrow band imaging, optical coherence tomography, and confocal laser endomicroscopy show promise for diagnosis, risk stratification, and disease monitoring. Attempts at better treatment, especially in refractory high-risk cases, include the addition of intravesical hyperthermia, combination and sequential therapy with existing agents, and the use novel agents such as Mycobacterial cell wall extract. New data is emerging regarding the potential role of active surveillance in low-risk patients. Summary NMIBC represents a variety of disease states and continues to pose management challenges. As our understanding of tumor biology improves and technology advances, achieving better outcomes through individualized care may be possible.

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Safety of Active Surveillance Program for Recurrent Nonmuscle-invasive Bladder Carcinoma

Cited by 34 publications

References 16 publications

Applicability of the EORTC risk tables to predict outcomes in non-muscle-invasive bladder cancer in Turkish patients

Applicability of the EORTC risk tables to predict outcomes in non-muscle-invasive bladder cancer in Turkish patients

The Role of Photodocumentation in Surveillance Cystoscopy for Bladder Cancer

Natural biology and management of nonmuscle invasive bladder cancer

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