title: Monitoring high-risk bladder cancer.
abstract: OBJECTIVE
  Monitoring high-risk nonmuscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) is challenging since currently used clinical and pathological risk parameters are not accurate enough to address the individual risk of progression.
  
  
  RESULTS
  In NMIBC, the use of urinary interleukin-2 and fluorescence in-situ hybridization predicts response to bacille-calmette-guerin treatment. In both NMIBC and MIBC, the detection of circulating tumor cells at initial diagnosis allows improved monitoring since its presence is associated with higher tumor stages, concomitant carcinoma in situ and shorter time to recurrence. Molecular urine markers, such as fluorescence-in-situ hybridization, help to identify high-risk cases early on. In MIBC, serum C-reactive protein and thrombocytosis have been recently incorporated into basic prognostic models and demonstrated an increase in the predictive accuracy of standard pathological risk factors.
  
  
  CONCLUSIONS
  New serological and urine-based markers have been identified for monitoring high-risk bladder cancer, and demand incorporation into established clinicopathological risk models to tailor surveillance regimens and provide improved prognostication for the need of adjuvant treatment.
authors: Department of Urology, Eberhard-Karls University, Tuebingen, Germany.
authors: Christian
authors: C
authors: Schwentner
authors: Arnulf
authors: A
authors: Stenzl
authors: Georgios
authors: G
authors: Gakis
mesh_terms: D001500:BCG Vaccine / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018450:Disease Progression; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D001500:BCG Vaccine; D014408:Biomarkers, Tumor