title: [CCAFU french national guidelines 2016-2018 on bladder cancer].
abstract: OBJECTIVE
  The purpose of the guidelines national committee CCAFU on bladder cancer was to propose updated french guidelines for non-muscle invasive (NMIBC) and invasive (MIBC) bladder cancers.
  
  
  METHODS
  A Medline search was achieved between 2013 and 2016, as regards diagnosis, options of treatment and follow-up of bladder cancer, to evaluate different references with levels of evidence.
  
  
  RESULTS
  Diagnosis of NMIBC (Ta, T1, CIS) is based on a complete deep resection of the tumour. The use of fluorescence and a second-look indication are essential to improve initial diagnosis. Risks of both recurrence and progression can be estimated using the EORTC score. A stratification of patients into low, intermediate and high risk groups is pivotal for recommending adjuvant treatment : instillation of chemotherapy (immediate post-operative, standard schedule) or intravesical BCG (standard schedule and maintenance). Cystectomy is recommended in BCG-refractory patients. Extension evaluation of MIBC is based on pelvic-abdominal and thoracic CT-scan; MRI and FDG-PET remain optional. Cystectomy associated with extensive pelvic lymph nodes resection is considered the gold standard for non metastatic MIBC. An orthotopic bladder substitution should be proposed to both male and female patients lacking any contraindications and in cases of negative frozen urethral samples. The interest of neoadjuvant chemotherapy is well known for all MIBC, wathever the stage. Thus, neoadjuvant chemotherapy is recommended for all eligible patients according PS (PS <2) and renal function (clearance > 60ml/mn). As regards metastatic MIBC, first-line chemotherapy using platin is recommended (GC or MVAC). In second line treatment, only chemotherapy using vinflunine has been validated to date, even if results of immunotherapy clinical trials are encouraging.
  
  
  CONCLUSIONS
  These updated french guidelines will contribute to increase the level of urological care for the diagnosis and treatment for NMIBC and MIBC. © 2016 Elsevier Masson SAS. All rights reserved.
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Rouprêt
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Neuzillet
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Masson-Lecomte
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Colin
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Compérat
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Dubosq
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Houédé
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Larré
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Pignot
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Puech
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Roumiguié
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Xylinas
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Méjean
mesh_terms: D000465:Algorithms; D006801:Humans; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000628:therapy*
keywords: (MeSH) Carcinome urothélial; (MeSH) Urothelial; BCG; Bladder tumours; Cancer; Cystectomie; Cystectomy; Cytologie urinaire; Cytology; Survie; Survival; Tumeurs de la vessie; carcinoma