title: Management of noninvasive bladder cancers.
abstract: OBJECTIVE
  To summarize clinical management of nonmuscle-invasive bladder cancer (NMIBC) and discuss recent advances in the field.
  
  
  RESULTS
  NMIBC remains a common and expensive clinical entity. Prevention, early detection, and risk-adapted treatment are the mainstays of clinical management, all of which may improve as a result of recent research. Photodynamic diagnosis has demonstrated improved detection of nascent disease, and specific clinical scenarios have been identified in which photodynamic diagnosis may improve clinical outcomes. New intravesical chemotherapeutic and immunotherapeutic agents challenge our current paradigm for intermediate/high-risk NMIBC and may delay need for cystectomy after bacillus Calmette-Guerin failure. Progress in risk stratification increasingly permits individualized management regimens for NMIBC.
  
  
  CONCLUSIONS
  NMIBC includes many heterogeneous disease states with a variety of clinical behaviors that may evolve over time. Improved detection and risk stratification promise assignment of the optimal treatment option for an individual patient at a given time.
authors.affiliation: Department of Urological Surgery, Vanderbilt University Medical Center, South Nashville, Tennessee, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Eifler
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Scarpato
authors.forename: Peter E
authors.initials: PE
authors.lastname: Clark
mesh_terms: D000283:Administration, Intravesical; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D015653:Cystectomy / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D055088:Early Detection of Cancer; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D014481:United States; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; C016163:valrubicin; D004317:Doxorubicin