[Nonmuscle-invasive bladder cancer (NMIBC): when to perform cystectomy?].
The reference treatment recommended for patients who have been diagnosed with a high-risk nonmuscle-invasive bladder cancer (NMIBC) is bacille Calmette-Guérin (BCG) therapy through intravesical instillations. Nevertheless, cystectomy can sometimes be indicated. Some of the clinical, endoscopic, and histological criteria indicating poor prognosis can identify very high-risk patients for whom immediate total cystectomy should be discussed. In addition, in cases of clear BCG treatment failure, cystectomy remains the reference treatment. In both cases (early, before BCG treatment, or after BCG treatment failure), this excision therapy should be practiced rapidly because the risk of progression is high and cystectomy tolerates no delay when indicated.
Lebret
Thierry
T
Service d'Urologie, Hôpital Foch, 40 rue Worth, Suresnes, France. t.lebret@hopital-foch.org
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use; D000283:Administration, Intravesical; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy; D003558:Cystoscopy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D018579:Patient Selection; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000093542:Gemcitabine
D000276:Adjuvants, Immunologic; D000964:Antimetabolites, Antineoplastic; D001500:BCG Vaccine; D003841:Deoxycytidine; D000093542:Gemcitabine