title: Active surveillance for low-risk bladder cancer.
abstract: BACKGROUND
  Most newly diagnosed bladder cancers present as non-muscle invasive bladder cancer (NMIBC). NMIBC is a heterogeneous disease with varying treatment options, follow-up schedules, and oncologic outcomes. We sought to review the role of active surveillance for low risk bladder cancer in the literature.
  
  
  METHODS
  A PubMed search was performed using the following keywords: active surveillance, low risk, bladder, transurethral resection of bladder tumor, cost, and quality of life. Relevant articles were reviewed and utilized.
  
  
  RESULTS
  Low-risk bladder cancer--defined as pTa low-grade papillary tumors--is the type of NMIBC with the most favorable oncologic outcome and which almost never progresses to muscle invasive disease or metastasizes. Bladder cancer has the highest per patient treatment costs of all cancers. One of the reasons is the high rate of recurrence. Patients with low-grade bladder tumors often experience a recurrence after primary transurethral resection. Many patients undergo multiple resections in the hospital.
  
  
  CONCLUSIONS
  Appropriately selected patients with recurrent low-risk bladder cancer could be managed with either office fulguration or cystoscopic surveillance. Active surveillance for patients with low-risk bladder cancer avoids or delays the surgical and anesthetic risks of a TURBT, thus optimizing quality of life without compromising the patient's risk of cancer progression.
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL. Electronic address: alberttiu@yahoo.com.
authors.forename: Albert
authors.initials: A
authors.lastname: Tiu
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Jenkins
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Soloway
mesh_terms: D003558:Cystoscopy; D018450:Disease Progression; D006801:Humans; D008495:Medical Oncology / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D011788:Quality of Life; D012306:Risk; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D014572:Urology / Q000379:methods
keywords: Active surveillance; Bladder cancer; Cost; Low risk; Quality of life; Transurethral resection of bladder tumor