Superficial bladder cancer: part 1. Update on etiology, classification and natural history.
Superficial 'nonmuscle-invasive' bladder tumors represent a heterogeneous group of cancers, which include those that are papillary in nature and limited to the mucosa (Ta), high grade, flat and confined to the epithelium (Tis) and those that invade the submucosa or lamina propria (T1). The natural history of these bladder cancers is that of disease recurrence and progression to higher grade and stage. Furthermore, recurrence and progression rates of superficial bladder cancer vary according to several tumor characteristics. The goal in the treatment of superficial bladder cancer is twofold: reducing tumor recurrence and the subsequent need for additional therapies, such as cystoscopy, transurethral resections, intravesical therapy and the morbidity associated with these treatments; and preventing tumor progression and the subsequent need for more aggressive therapy, such as radical cystectomy. The administration of intravesical chemotherapy and immunotherapy has become an important component in accomplishing these goals. This update is the first part of two articles reviewing important contemporary concepts in the etiology, classification and natural history of superficial bladder cancer, while part II of the series will review and highlight important aspects in management of superficial bladder cancer.
Josephson
David Y
DY
University of Southern California, Department of Urology, Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles CA, USA. david.josephson@usc.edu
Pasin
Erik
E
Stein
John P
JP
D002274:Carcinogens, Environmental / Q000009:adverse effects; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology; D002295:Carcinoma, Transitional Cell / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000235:genetics / Q000473:pathology / Q000628:therapy; D002869:Chromosome Aberrations; D003937:Diagnosis, Differential; D018450:Disease Progression; D006417:Hematuria / Q000209:etiology; D006801:Humans; D009092:Mucous Membrane / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009784:Occupational Diseases / Q000139:chemically induced; D010212:Papilloma / Q000175:diagnosis / Q000473:pathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D001749:Urinary Bladder Neoplasms / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000235:genetics / Q000473:pathology / Q000628:therapy; D014552:Urinary Tract Infections / Q000175:diagnosis
D002274:Carcinogens, Environmental