[Management of Ta, T1, and in situ bladder carcinoma: what is new?].
Since a recent time, some changes were made in the management of nonmuscle-invasive bladder cancer. Second-look resection is efficient in patients with high risk superficial tumors. The interest of resection under fluorescence is still discussed. The new classification in high grade and low grade tumors is progressively replacing the G1-G2-G3 grade classification. New prognosis markers appear such as lamina propria invasion microstaging and prostatic urethra involvement. Immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer. Intravesical Mitomycin C can be optimized to significantly enhance its efficacy. Intravesical Bacillus Calmette-Guérin (BCG) appears to be the treatment of choice for the management of carcinoma in situ, and is superior to Mitomycin C in reducing tumor recurrence in high-risk nonmuscle-invasive bladder cancer. In addition, intravesical BCG significantly reduces the risk of progression after transurethral resection in patients with nonmuscle-invasive bladder cancer who receive maintenance treatment.
Irani
Jacques
J
Service d'Urologie, CHU la Milétrie, 86000 Poitiers. j.irani@chu-poitiers.fr
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011182:Postoperative Care; D011379:Prognosis; D012086:Reoperation; D012307:Risk Factors; D012737:Sex Factors; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*
D000276:Adjuvants, Immunologic; D000903:Antibiotics, Antineoplastic; D001500:BCG Vaccine; D016685:Mitomycin