title: Perioperative management of nonmuscle-invasive bladder cancer.
abstract: OBJECTIVE
  The management of nonmuscle-invasive bladder cancer is a challenge. Despite current guidelines, the treatment is suboptimal as illustrated by the high risk of recurrence and progression. Transurethral resection plays a pivotal role in the management of bladder cancer, but the quality varies dramatically. In this review, we discuss the latest developments that aim to improve the outcome of a transurethral resection such as photodynamic diagnosis, a second resection and adjuvant therapy.
  
  
  RESULTS
  The treatment of a bladder cancer patient can be improved, for example, with a standard second resection in a subset of the patients or the use of visual enhancement techniques. There is conflicting data on the clinical value of techniques like photodynamic diagnosis, as it does not always seem to translate into a better long-term outcome. Comparison of studies is difficult because of differences in patient selection and endpoints. Better classification in (personalized) risk categories may facilitate the treatment choice and prediction of the long-term outcome.
  
  
  CONCLUSIONS
  The outcome of bladder cancer patients can be improved. A good-quality transurethral resection of the bladder tumor is crucial and novel technological developments may improve the outcome, but they remain the subject of discussion.
authors.affiliation: Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Falke
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
mesh_terms: D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D010778:Photochemotherapy; D012086:Reoperation; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000601:surgery*