Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
World Journal of Urology
Erschienen in: World Journal of Urology 6/2012

01.12.2012 | Invited Review

High-risk non-muscle-invasive bladder cancer: update for a better identification and treatment

verfasst von: Oscar Rodriguez Faba, Joan Palou, Alberto Breda, H. Villavicencio

Erschienen in: World Journal of Urology | Ausgabe 6/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Despite standard treatment with transurethral resection (TUR) and adjuvant bacillus Calmette–Guérin (BCG), many high-risk bladder cancers (HRBCs) recur and some progress. Based on a review of the literature, we aimed to establish the optimal current approach for the early diagnosis and management of HRBC.

Methods

A MEDLINE® search was conducted to identify the published literature relating to early identification and treatment for non-muscle-invasive bladder cancer. Particular attention was paid to factors such as quality of TUR, importance of second TUR, substaging, and CIS. In addition, studies on urinary markers, photodynamic diagnosis, predictive clinical and molecular factors for recurrence and progression after BCG, and best management practice were analysed.

Results and conclusions

Good quality of TUR and the implementation of photodynamic diagnosis in selected cases provide a more accurate diagnosis and reduce the risk of residual tumour in HRBC. Although insufficient evidence is available to warrant the use of new urinary molecular markers in isolation, their use in conjunction with cytology and cystoscopy may improve early diagnosis and follow-up. BCG plus maintenance for at least 1 year remains the standard adjuvant treatment for HRBC. Moreover, there is enough evidence to consider the implementation of new specific risk tables for patients treated with BCG. In HRBC patients with poor prognostic factors after TUR, early cystectomy should be considered.
Literatur
1.
Brausi M, Witjes JA, Lamm D et al (2011) A review of current guidelines and best practice recommendations for the management of nonmuscle invasive bladder cancer by the International Bladder Cancer Group. J Urol 186:2158–2167PubMedCrossRef
2.
Sylvester RJ, van der Meijden AP, Oosterlinck W et al (2006) 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 49:466–475 (discussion 475–7)PubMedCrossRef
3.
Babjuk M, Oosterlinck W, Sylvester R et al (2008) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 54:303–314PubMedCrossRef
4.
NCCN (2010) Clinical practise guidelines in oncology: bladder cancer including upper tract tumours and urothelial carcinoma of the prostate. Version 2. Jenkintown. Pennsylvania.NCCN 2010. http://​www.​ncc.​org
5.
6.
Palou J, Sylvester RJ, Rodriguez Faba O et al (2012) Female gender and carcinoma in situ in the prostatic urethra are prognostic factors for recurrence, progression, and disease-specific mortality in T1G3 bladder cancer patients treated with Bacillus Calmette-Guerin. Eur Urol 62(1):118–125PubMedCrossRef
7.
Fernandez-Gomez J, Madero R, Solsona E et al (2011) The EORTC tables overestimate the risk of recurrence and progression in patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Guerin: external validation of the EORTC risk tables. Eur Urol 60:423–430PubMedCrossRef
8.
Agundez M, Grau L, Palou J et al (2011) Evaluation of the methylation status of tumour suppressor genes for predicting bacillus Calmette-Guerin response in patients with T1G3 high-risk bladder tumours. Eur Urol 60:131–140PubMedCrossRef
9.
Nieder AM, Brausi M, Lamm D et al (2005) Management of stage T1 tumors of the bladder: international consensus panel. Urology 66:108–125PubMedCrossRef
10.
Sylvester RJ, van der Meijden A, Witjes JA et al (2005) High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder. Urology 66:90–107PubMedCrossRef
11.
Nagele U, Kugler M, Nicklas A et al (2011) Waterjet hydrodissection: first experiences and short-term outcomes of a novel approach to bladder tumor resection. World J Urol 29:423–427PubMedCrossRef
12.
Wolters M, Kramer MW, Becker JU et al (2011) Tm:YAG laser en bloc mucosectomy for accurate staging of primary bladder cancer: early experience. World J Urol 29:429–432PubMedCrossRef
13.
Babjuk M, Oosterlinck W, Sylvester R et al (2011) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2011 update. Eur Urol 59:997–1008PubMedCrossRef
14.
Palou J, Rodriguez O, Segarra J et al (2006) Re: Restaging transurethral resection of high risk superficial bladder cancer improves the initial response to bacillus Calmette-Guerin therapy. J Urol 176:407 (author reply 407–8)PubMedCrossRef
15.
Brausi M, Collette L, Kurth K et al (2002) Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol 41:523–531PubMedCrossRef
16.
Mariappan P, Finney SM, Head E et al (2012) Good quality white-light transurethral resection of bladder tumours (GQ-WLTURBT) with experienced surgeons performing complete resections and obtaining detrusor muscle reduces early recurrence in new non-muscle-invasive bladder cancer: validation across time and place and recommendation for benchmarking. BJU Int 109(11):1666–1673PubMedCrossRef
17.
Richterstetter M, Wullich B, Amann K et al (2012) The value of extended transurethral resection of bladder tumour (TURBT) in the treatment of bladder cancer. BJU Int 110(2 Pt 2):E76–E79PubMedCrossRef
18.
Jahnson S, Wiklund F, Duchek M et al (2005) Results of second-look resection after primary resection of T1 tumour of the urinary bladder. Scand J Urol Nephrol 39:206–210PubMed
19.
Schips L, Augustin H, Zigeuner RE et al (2002) Is repeated transurethral resection justified in patients with newly diagnosed superficial bladder cancer? Urology 59:220–223PubMedCrossRef
20.
Herr HW (2005) Restaging transurethral resection of high risk superficial bladder cancer improves the initial response to bacillus Calmette-Guerin therapy. J Urol 174:2134–2137PubMedCrossRef
21.
Rigaud J, Karam G, Braud G et al (2002) T1 bladder tumors: value of a second endoscopic resection. Prog Urol 12:27–30PubMed
22.
Ozen H, Ekici S, Uygur MC et al (2001) Repeated transurethral resection and intravesical BCG for extensive superficial bladder tumors. J Endourol 15:863–867PubMedCrossRef
23.
Gaya JM, Palou J, Cosentino M et al. (2012) A second transurethral resection could be not necessary in all high grade non-muscle-invasive bladder tumors. Actas Urol Esp (Epub ahead of print; English, Spanish) (2012 Jun 16)
24.
Kim W, Song C, Park S et al (2012) Value of immediate second resection of the tumor bed to improve the effectiveness of transurethral resection of bladder tumor. J Endourol 26(8):1059–1064PubMedCrossRef
25.
Thorstenson A, Schumacher MC, Wiklund NP et al (2010) Diagnostic random bladder biopsies: reflections from a population-based cohort of 538 patients. Scand J Urol Nephrol 44:11–19PubMedCrossRef
26.
Meijer RP, van Onna IE, Kok ET et al (2011) The risk profiles of three clinical types of carcinoma in situ of the bladder. BJU Int 108:839–843PubMed
27.
Millan-Rodriguez F, Chechile-Toniolo G, Salvador-Bayarri J et al (2000) Primary superficial bladder cancer risk groups according to progression, mortality and recurrence. J Urol 164:680–684PubMedCrossRef
28.
Burgues JP, Conde G, Oliva J et al (2011) Hexaminolevulinate photodynamic diagnosis in non-muscle invasive bladder cancer: experience of the BLUE group. Actas Urol Esp 35:439–445PubMedCrossRef
29.
Huguet J, Gaya JM, Sabate S et al (2010) Radical cystectomy in patients with non-muscle invasive bladder cancer who fail BCG therapy. Actas Urol Esp 34:63–70PubMedCrossRef
30.
Green DA, Rink M, Hansen J et al. (2012) Accurate preoperative prediction of non-organ-confined bladder urothelial carcinoma at cystectomy. BJU Int [Epub ahead of print]
31.
Kramer MW, Waalkes S, Serth J et al (2011) Decreased galectin-8 is a strong marker for recurrence in urothelial carcinoma of the bladder. Urol Int 87:143–150PubMedCrossRef
32.
Orsola A, Trias I, Raventos CX et al (2005) Initial high-grade T1 urothelial cell carcinoma: feasibility and prognostic significance of lamina propria invasion microstaging (T1a/b/c) in BCG-treated and BCG-non-treated patients. Eur Urol 48:231–238 (discussion 238)PubMedCrossRef
33.
Cheng L, Montironi R, Davidson DD et al (2009) Staging and reporting of urothelial carcinoma of the urinary bladder. Mod Pathol 22(Suppl 2):S70–S95PubMedCrossRef
34.
Chang WC, Chang YH, Pan CC (2012) Prognostic significance in substaging of T1 urinary bladder urothelial carcinoma on transurethral resection. Am J Surg Pathol 36:454–461PubMedCrossRef
35.
van Rhijn BW, van der Kwast TH, Alkhateeb SS et al (2012) A new and highly prognostic system to discern T1 bladder cancer substage. Eur Urol 61:378–384PubMedCrossRef
36.
Otto W, Denzinger S, Fritsche HM et al (2011) The WHO classification of 1973 is more suitable than the WHO classification of 2004 for predicting survival in pT1 urothelial bladder cancer. BJU Int 107:404–408PubMedCrossRef
37.
38.
Lotan Y, Shariat SF, Schmitz-Drager BJ et al (2010) Considerations on implementing diagnostic markers into clinical decision making in bladder cancer. Urol Oncol 28:441–448PubMedCrossRef
39.
Shariat SF, Karam JA, Lerner SP (2008) Molecular markers in bladder cancer. Curr Opin Urol 18:1–8PubMedCrossRef
40.
Shirodkar SP, Lokeshwar VB (2009) Potential new urinary markers in the early detection of bladder cancer. Curr Opin Urol 19:488–493PubMedCrossRef
41.
Mowatt G, Zhu S, Kilonzo M et al (2010) Systematic review of the clinical effectiveness and cost-effectiveness of photodynamic diagnosis and urine biomarkers (FISH, ImmunoCyt, NMP22) and cytology for the detection and follow-up of bladder cancer. Health Technol Assess 14:1–331 (iii–iv)
42.
Hajdinjak T (2008) UroVysion FISH test for detecting urothelial cancers: meta-analysis of diagnostic accuracy and comparison with urinary cytology testing. Urol Oncol 26:646–651PubMedCrossRef
43.
Schmitz-Drager BJ, Beiche B, Tirsar LA et al (2007) Immunocytology in the assessment of patients with asymptomatic microhaematuria. Eur Urol 51:1582–1588 (discussion 1588)PubMedCrossRef
44.
Fritsche HM, Burger M, Dietmaier W et al (2010) Multicolor FISH (UroVysion) facilitates follow-up of patients with high-grade urothelial carcinoma of the bladder. Am J Clin Pathol 134:597–603PubMedCrossRef
45.
Nguyen CT, Jones JS (2008) Defining the role of NMP22 in bladder cancer surveillance. World J Urol 26:51–58PubMedCrossRef
46.
Huber SSC, Taeger D, Pesch B, Nasterlack M, Leng G, Mayer T, Gawrych KBN, Pelster M, Johnen G, Bontrup H, Wellhäußer H, Bierfreund HG, Wiens CBC, Eberle F, Scheuermann B, Kluckert M, Feil G, Brüning T, Stenzl A et al (2012) (2012) Nuclear matrix protein-22: a prospective evaluation in a population at risk for bladder cancer. Results from the UroScreen study. BJU Int 110(5):699–708PubMedCrossRef
47.
Mian C, Lodde M, Comploj E et al (2005) The value of the ImmunoCyt/uCyt + test in the detection and follow-up of carcinoma in situ of the urinary bladder. Anticancer Res 25:3641–3644PubMed
48.
Babjuk M, Soukup V, Pesl M et al (2008) Urinary cytology and quantitative BTA and UBC tests in surveillance of patients with pTapT1 bladder urothelial carcinoma. Urology 71:718–722PubMedCrossRef
49.
Raitanen MP, FinnBladder G (2008) The role of BTA stat Test in follow-up of patients with bladder cancer: results from FinnBladder studies. World J Urol 26:45–50PubMedCrossRef
50.
Tilki D, Burger M, Dalbagni G et al (2011) Urine markers for detection and surveillance of non-muscle-invasive bladder cancer. Eur Urol 60:484–492PubMedCrossRef
51.
Jocham D, Witjes F, Wagner S et al (2005) Improved detection and treatment of bladder cancer using hexaminolevulinate imaging: a prospective, phase III multicenter study. J Urol 174:862–866 (discussion 866)PubMedCrossRef
52.
Jichlinski P, Guillou L, Karlsen SJ et al (2003) Hexyl aminolevulinate fluorescence cystoscopy: new diagnostic tool for photodiagnosis of superficial bladder cancer–a multicenter study. J Urol 170:226–229PubMedCrossRef
53.
Kausch I, Sommerauer M, Montorsi F et al (2010) Photodynamic diagnosis in non-muscle-invasive bladder cancer: a systematic review and cumulative analysis of prospective studies. Eur Urol 57:595–606PubMedCrossRef
54.
Geavlete B, Multescu R, Georgescu D et al (2012) Treatment changes and long-term recurrence rates after hexaminolevulinate (HAL) fluorescence cystoscopy: does it really make a difference in patients with non-muscle-invasive bladder cancer (NMIBC)? BJU Int 109:549–556PubMedCrossRef
55.
Lapini A, Minervini A, Masala A et al (2012) A comparison of hexaminolevulinate (Hexvix((R))) fluorescence cystoscopy and white-light cystoscopy for detection of bladder cancer: results of the HeRo observational study. Surg Endosc [Epub ahead of print]
56.
Soloway MS, Bruck DS, Kim SS (2003) Expectant management of small, recurrent, noninvasive papillary bladder tumors. J Urol 170:438–441PubMedCrossRef
57.
Raj GV, Herr H, Serio AM et al (2007) Treatment paradigm shift may improve survival of patients with high risk superficial bladder cancer. J Urol 177:1283–1286 (discussion 1286)PubMedCrossRef
58.
Fernandez-Gomez J, Solsona E, Unda M et al (2008) Prognostic factors in patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Guerin: multivariate analysis of data from four randomized CUETO trials. Eur Urol 53:992–1001PubMedCrossRef
59.
Fernandez-Gomez J, Madero R, Solsona E et al (2009) Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with bacillus Calmette-Guerin: the CUETO scoring model. J Urol 182:2195–2203PubMedCrossRef
60.
Bertz S, Otto W, Denzinger S et al (2012) Combination of CK20 and Ki-67 immunostaining analysis predicts recurrence, progression, and cancer-specific survival in pT1 urothelial bladder cancer. Eur Urol (Epub ahead of print) (May 19)
61.
Shariat SF, Bolenz C, Godoy G et al (2009) Predictive value of combined immunohistochemical markers in patients with pT1 urothelial carcinoma at radical cystectomy. J Urol 182:78–84 (discussion 84)
62.
Palou J, Algaba F, Vera I et al (2009) Protein expression patterns of ezrin are predictors of progression in T1G3 bladder tumours treated with nonmaintenance bacillus Calmette-Guerin. Eur Urol 56:829–836
63.
Fristrup N, Ulhoi BP, Birkenkamp-Demtroder K et al (2012) Cathepsin e, maspin, plk1, and survivin are promising prognostic protein markers for progression in non-muscle invasive bladder cancer. Am J Pathol 180:1824–1834
64.
Zoidakis J, Makridakis M, Zerefos PG et al (2011) Profilin 1 is a potential biomarker for bladder cancer aggressiveness. Mol Cell Proteomics 11(4) [Epub of ahead of print]
65.
Tilki D, Singer BB, Shariat SF et al (2010) CEACAM1: a novel urinary marker for bladder cancer detection. Eur Urol 57:648–654
66.
Reinert T, Modin C, Castano FM et al (2011) Comprehensive genome methylation analysis in bladder cancer: identification and validation of novel methylated genes and application of these as urinary tumor markers. Clin Cancer Res 17:5582–5592
67.
Kulkarni GS, Hakenberg OW, Gschwend JE et al (2010) An updated critical analysis of the treatment strategy for newly diagnosed high-grade T1 (previously T1G3) bladder cancer. Eur Urol 57:60–70
68.
Morales A, Eidinger D, Bruce AW (1976) Intracavitary Bacillus Calmette-Guerin in the treatment of superficial bladder tumors. J Urol 116:180–183
69.
Lamm DL, Blumenstein BA, Crissman JD et al (2000) Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol 163:1124–1129
70.
Malmstrom PU, Sylvester RJ, Crawford DE et al (2009) An individual patient data meta-analysis of the long-term outcome of randomised studies comparing intravesical mitomycin C versus bacillus Calmette-Guerin for non-muscle-invasive bladder cancer. Eur Urol 56:247–256
71.
Sylvester RJ, van der MA, Lamm DL (2002) Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol 168:1964–1970
72.
Martinez-Pineiro JA, Flores N, Isorna S et al (2002) Long-term follow-up of a randomized prospective trial comparing a standard 81 mg dose of intravesical bacille Calmette-Guerin with a reduced dose of 27 mg in superficial bladder cancer. BJU Int 89:671–680
73.
Schrier BP, Hollander MP, van Rhijn BW et al (2004) Prognosis of muscle-invasive bladder cancer: difference between primary and progressive tumours and implications for therapy. Eur Urol 45:292–296
74.
Kotb AF, Kovac E, Kassouf W et al (2012) Radical cystectomy for clinically muscle invasive bladder cancer: does prior non-invasive disease affect clinical outcomes? World J Urol [Epub ahead of print]
75.
van den Bosch S, Alfred Witjes J (2011) Long-term cancer-specific survival in patients with high-risk, non-muscle-invasive bladder cancer and tumour progression: a systematic review. Eur Urol 60:493–500
76.
Shariat SF, Palapattu GS, Amiel GE et al (2006) Characteristics and outcomes of patients with carcinoma in situ only at radical cystectomy. Urology 68:538–542
77.
Malavaud B (2004) T1G3 bladder tumours: the case for radical cystectomy. Eur Urol 45:406–410
78.
Badalato GM, Gaya JM, Hruby G et al (2012) Immediate radical cystectomy vs conservative management for high grade cT1 bladder cancer: is there a survival difference? BJU Int [Epub ahead of print]
Metadaten
Titel
High-risk non-muscle-invasive bladder cancer: update for a better identification and treatment
verfasst von
Oscar Rodriguez Faba
Joan Palou
Alberto Breda
H. Villavicencio
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
World Journal of Urology / Ausgabe 6/2012
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-012-0967-1

Weitere Artikel der Ausgabe 6/2012

World Journal of Urology 6/2012 Zur Ausgabe

Original Article

Does increasing the nodal yield improve outcomes in patients without nodal metastasis at radical cystectomy?

Original Article

Multicenter validation of the prognostic value of patient age in patients treated with radical cystectomy

Original Article

Factors associated with non-orthotopic urinary diversion after radical cystectomy

Original Article

Outcomes following radical cystectomy for micropapillary bladder cancer versus pure urothelial carcinoma: a matched cohort analysis

Topic Paper

Radical cystectomy with orthotopic neobladder for invasive bladder cancer: a critical analysis of long-term oncological, functional, and quality of life results

Original Article

Establishment of a protocol for large-scale gene expression analyses of laser capture microdissected bladder tissue

Neu im Fachgebiet Urologie

25.04.2024 | Nierenkarzinom | Nachrichten

Adjuvante Immuntherapie verlängert Leben bei RCC

24.04.2024 | DGIM 2024 | Nachrichten

Bei Senioren mit Prostatakarzinom auf Anämie achten!

22.04.2024 | Prostatakarzinom | Nachrichten

Stufenschema weist Prostatakarzinom zuverlässig nach

20.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika
weitere anzeigen

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen