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Erschienen in: Current Urology Reports 12/2015

01.12.2015 | INVITED COMMENTARY

Expectant Management of Low-Risk Bladder Cancer

verfasst von: Zachary L. Smith, Mark S. Soloway

Erschienen in: Current Urology Reports | Ausgabe 12/2015

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Abstract

Patients with one or more low-grade bladder tumors of the urinary bladder will often develop a subsequent tumor but these so called “recurrences” are almost always of similar grade and rarely invade beyond the basement membrane. Therefore, the clinician should try to minimize the morbidity associated with treating these new tumors. Since many of these patients are elderly or have comorbidities, active surveillance is a very reasonable initial approach if these tumors are very small and appear low-grade. Another alternative is fulguration in the outpatient setting using a flexible cystoscope and electrode. The goal is to try to avoid the hospital and performing a formal transurethral resection. This adds potential morbidity, inconvenience, and cost.
Literatur
1.
2.
Zurück zum Zitat Rübben H, Lutzeyer W, Fischer N, Deutz F, Lagrange W, Giani G. Natural history and treatment of low and high risk superficial bladder tumors. J Urol. 1988;139:283–5.PubMed Rübben H, Lutzeyer W, Fischer N, Deutz F, Lagrange W, Giani G. Natural history and treatment of low and high risk superficial bladder tumors. J Urol. 1988;139:283–5.PubMed
3.
Zurück zum Zitat Prout GR, Barton BA, Griffin PP, Friedell GH. Treated history of noninvasive grade 1 transitional cell carcinoma. The National Bladder Cancer Group. J UroL. 1992;148:1413–9.PubMed Prout GR, Barton BA, Griffin PP, Friedell GH. Treated history of noninvasive grade 1 transitional cell carcinoma. The National Bladder Cancer Group. J UroL. 1992;148:1413–9.PubMed
4.
Zurück zum Zitat Sylvester RJ, van der Meijden APM, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006;49:466–5. discussion 475–7.CrossRefPubMed Sylvester RJ, van der Meijden APM, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006;49:466–5. discussion 475–7.CrossRefPubMed
5.
Zurück zum Zitat van Rhijn BWG, Burger M, Lotan Y, Solsona E, Stief CG, Sylvester RJ, et al. Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol. 2009;56:430–42.CrossRefPubMed van Rhijn BWG, Burger M, Lotan Y, Solsona E, Stief CG, Sylvester RJ, et al. Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol. 2009;56:430–42.CrossRefPubMed
6.
Zurück zum Zitat Burger M, Catto JWF, Dalbagni G, Grossman HB, Herr H, Karakiewicz P, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2013;63:234–41.CrossRefPubMed Burger M, Catto JWF, Dalbagni G, Grossman HB, Herr H, Karakiewicz P, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2013;63:234–41.CrossRefPubMed
7.
Zurück zum Zitat Nielsen ME, Smith AB, Meyer A-M, Kuo T-M, Tyree S, Kim WY, et al. Trends in stage-specific incidence rates for urothelial carcinoma of the bladder in the United States: 1988 to 2006. Cancer. 2014;120:86–95.PubMedCentralCrossRefPubMed Nielsen ME, Smith AB, Meyer A-M, Kuo T-M, Tyree S, Kim WY, et al. Trends in stage-specific incidence rates for urothelial carcinoma of the bladder in the United States: 1988 to 2006. Cancer. 2014;120:86–95.PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Holmäng S, Andius P, Hedelin H, Wester K, Busch C, Johansson SL. Stage progression in Ta papillary urothelial tumors: relationship to grade, immunohistochemical expression of tumor markers, mitotic frequency and DNA ploidy. J Urol. 2001;165:1124–8. discussion 1128–30.CrossRefPubMed Holmäng S, Andius P, Hedelin H, Wester K, Busch C, Johansson SL. Stage progression in Ta papillary urothelial tumors: relationship to grade, immunohistochemical expression of tumor markers, mitotic frequency and DNA ploidy. J Urol. 2001;165:1124–8. discussion 1128–30.CrossRefPubMed
9.
Zurück zum Zitat Lapham RL, Ro JY, Staerkel GA, Ayala AG. Pathology of transitional cell carcinoma of the bladder and its clinical implications. Semin Surg Oncol. 1997;13:307–18.CrossRefPubMed Lapham RL, Ro JY, Staerkel GA, Ayala AG. Pathology of transitional cell carcinoma of the bladder and its clinical implications. Semin Surg Oncol. 1997;13:307–18.CrossRefPubMed
10.
Zurück zum Zitat Soloway MS, Bruck DS, Kim SS. Expectant management of small, recurrent, noninvasive papillary bladder tumors. J Urol. 2003;170:438–41.CrossRefPubMed Soloway MS, Bruck DS, Kim SS. Expectant management of small, recurrent, noninvasive papillary bladder tumors. J Urol. 2003;170:438–41.CrossRefPubMed
11.
Zurück zum Zitat Gofrit ON, Pode D, Lazar A, Katz R, Shapiro A. Watchful waiting policy in recurrent Ta G1 bladder tumors. Eur Urol. 2006;49:303–6. discussion 306–7.CrossRefPubMed Gofrit ON, Pode D, Lazar A, Katz R, Shapiro A. Watchful waiting policy in recurrent Ta G1 bladder tumors. Eur Urol. 2006;49:303–6. discussion 306–7.CrossRefPubMed
12.
Zurück zum Zitat Pruthi RS, Baldwin N, Bhalani V, Wallen EM. Conservative management of low risk superficial bladder tumors. J Urol. 2008;179:87–90. discussion 90.CrossRefPubMed Pruthi RS, Baldwin N, Bhalani V, Wallen EM. Conservative management of low risk superficial bladder tumors. J Urol. 2008;179:87–90. discussion 90.CrossRefPubMed
13.
Zurück zum Zitat Gofrit ON, Shapiro A. Active surveillance of low grade bladder tumors. Arch Ital Urol Androl. 2008;80:132–5.PubMed Gofrit ON, Shapiro A. Active surveillance of low grade bladder tumors. Arch Ital Urol Androl. 2008;80:132–5.PubMed
14.
Zurück zum Zitat Hernández V, Alvarez M, la Peña de E, Amaruch N, Martín MD, La Morena de JM, et al. Safety of active surveillance program for recurrent nonmuscle-invasive bladder carcinoma. Urology. 2009;73:1306–10.CrossRefPubMed Hernández V, Alvarez M, la Peña de E, Amaruch N, Martín MD, La Morena de JM, et al. Safety of active surveillance program for recurrent nonmuscle-invasive bladder carcinoma. Urology. 2009;73:1306–10.CrossRefPubMed
15.
Zurück zum Zitat Jordan AM, Weingarten J, Murphy WM. Transitional cell neoplasms of the urinary bladder. Can biologic potential be predicted from histologic grading? Cancer. 1987;60:2766–74.CrossRefPubMed Jordan AM, Weingarten J, Murphy WM. Transitional cell neoplasms of the urinary bladder. Can biologic potential be predicted from histologic grading? Cancer. 1987;60:2766–74.CrossRefPubMed
16.
Zurück zum Zitat Herr HW. Does cystoscopy correlate with the histology of recurrent papillary tumours of the bladder? BJU Int. 2001;88:683–5.CrossRefPubMed Herr HW. Does cystoscopy correlate with the histology of recurrent papillary tumours of the bladder? BJU Int. 2001;88:683–5.CrossRefPubMed
17.
Zurück zum Zitat Hall MC, Chang SS, Dalbagni G, Pruthi RS, Seigne JD, Skinner EC, et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol. 2007;178:2314–30.CrossRefPubMed Hall MC, Chang SS, Dalbagni G, Pruthi RS, Seigne JD, Skinner EC, et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol. 2007;178:2314–30.CrossRefPubMed
18.
Zurück zum Zitat Manikandan R, Lynch N, Grills RJ. Percutaneous peritoneal drainage for intraperitoneal bladder perforations during transurethral resection of bladder tumors. J Endourol. 2003;17:945–7.CrossRefPubMed Manikandan R, Lynch N, Grills RJ. Percutaneous peritoneal drainage for intraperitoneal bladder perforations during transurethral resection of bladder tumors. J Endourol. 2003;17:945–7.CrossRefPubMed
19.
Zurück zum Zitat Collado A, Chéchile GE, Salvador J, Vicente J. Early complications of endoscopic treatment for superficial bladder tumors. J Urol. 2000;164:1529–32.CrossRefPubMed Collado A, Chéchile GE, Salvador J, Vicente J. Early complications of endoscopic treatment for superficial bladder tumors. J Urol. 2000;164:1529–32.CrossRefPubMed
20.
Zurück zum Zitat Balbay MD, Cimentepe E, Unsal A, Bayrak O, Koç A, Akbulut Z. The actual incidence of bladder perforation following transurethral bladder surgery. J Urol. 2005;174:2260–2. discussion 2262–3.CrossRefPubMed Balbay MD, Cimentepe E, Unsal A, Bayrak O, Koç A, Akbulut Z. The actual incidence of bladder perforation following transurethral bladder surgery. J Urol. 2005;174:2260–2. discussion 2262–3.CrossRefPubMed
21.
Zurück zum Zitat Weldon TE, Soloway MS, Persky L. Urothelial susceptibility to neoplastic cellular implantation. Surg Forum. 1974;25:547–9.PubMed Weldon TE, Soloway MS, Persky L. Urothelial susceptibility to neoplastic cellular implantation. Surg Forum. 1974;25:547–9.PubMed
22.
Zurück zum Zitat Weldon TE, Soloway MS. Susceptibility of urothelium to neoplastic cellular implantation. Urology. 1975;5:824–7.CrossRefPubMed Weldon TE, Soloway MS. Susceptibility of urothelium to neoplastic cellular implantation. Urology. 1975;5:824–7.CrossRefPubMed
23.
Zurück zum Zitat Soloway MS, Masters S. Urothelial susceptibility to tumor cell implantation: influence of cauterization. Cancer. 1980;46:1158–63.CrossRefPubMed Soloway MS, Masters S. Urothelial susceptibility to tumor cell implantation: influence of cauterization. Cancer. 1980;46:1158–63.CrossRefPubMed
24.
Zurück zum Zitat Soloway MS, Nissenkorn I, McCallum L. Urothelial susceptibility to tumor cell implantation: comparison of cauterization with N-methyl-N-nitrosourea. Urology. 1983;21:159–61.CrossRefPubMed Soloway MS, Nissenkorn I, McCallum L. Urothelial susceptibility to tumor cell implantation: comparison of cauterization with N-methyl-N-nitrosourea. Urology. 1983;21:159–61.CrossRefPubMed
25.
Zurück zum Zitat Botteman MF, Pashos CL, Redaelli A, Laskin B, Hauser R. The health economics of bladder cancer: a comprehensive review of the published literature. Pharmacoeconomics. 2003;21:1315–30.CrossRefPubMed Botteman MF, Pashos CL, Redaelli A, Laskin B, Hauser R. The health economics of bladder cancer: a comprehensive review of the published literature. Pharmacoeconomics. 2003;21:1315–30.CrossRefPubMed
26.
Zurück zum Zitat Svatek RS, Hollenbeck BK, Holmäng S, Lee R, Kim SP, Stenzl A, et al. The economics of bladder cancer: costs and considerations of caring for this disease. Eur Urol. 2014;66:253–62.CrossRefPubMed Svatek RS, Hollenbeck BK, Holmäng S, Lee R, Kim SP, Stenzl A, et al. The economics of bladder cancer: costs and considerations of caring for this disease. Eur Urol. 2014;66:253–62.CrossRefPubMed
Metadaten
Titel
Expectant Management of Low-Risk Bladder Cancer
verfasst von
Zachary L. Smith
Mark S. Soloway
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 12/2015
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-015-0555-1

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