Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline

No AccessJournal of UrologyAdult Urology1 Oct 2016Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline Sam S. Chang, Stephen A. Boorjian, Roger Chou, Peter E. Clark, Siamak Daneshmand, Badrinath R. Konety, Raj Pruthi, Diane Z. Quale, Chad R. Ritch, John D. Seigne, Eila Curlee Skinner, Norm D. Smith, and James M. McKiernan Sam S. ChangSam S. Chang More articles by this author , Stephen A. BoorjianStephen A. Boorjian More articles by this author , Roger ChouRoger Chou More articles by this author , Peter E. ClarkPeter E. Clark More articles by this author , Siamak DaneshmandSiamak Daneshmand More articles by this author , Badrinath R. KonetyBadrinath R. Konety More articles by this author , Raj PruthiRaj Pruthi More articles by this author , Diane Z. QualeDiane Z. Quale More articles by this author , Chad R. RitchChad R. Ritch More articles by this author , John D. SeigneJohn D. Seigne More articles by this author , Eila Curlee SkinnerEila Curlee Skinner More articles by this author , Norm D. SmithNorm D. Smith More articles by this author , and James M. McKiernanJames M. McKiernan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.06.049AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Although associated with an overall favorable survival rate, the heterogeneity of non-muscle invasive bladder cancer (NMIBC) affects patients’ rates of recurrence and progression. Risk stratification should influence evaluation, treatment and surveillance. This guideline attempts to provide a clinical framework for the management of NMIBC. Materials and Methods: A systematic review utilized research from the Agency for Healthcare Research and Quality (AHRQ) and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions.1 Results: A risk-stratified approach categorizes patients into broad groups of low-, intermediate-, and high-risk. Importantly, the evaluation and treatment algorithm takes into account tumor characteristics and uniquely considers a patient’s response to therapy. The 38 statements vary in level of evidence, but none include Grade A evidence, and many were Grade C. Conclusion: The intensity and scope of care for NMIBC should focus on patient, disease, and treatment response characteristics. This guideline attempts to improve a clinician’s ability to evaluate and treat each patient, but higher quality evidence in future trials will be essential to improve level of care for these patients. 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3, (655-662), Online publication date: 1-Mar-2018.Chang S (2017) Re: The Impact of Re-Transurethral Resection on Clinical Outcomes in a Large Multicentre Cohort of Patients with T1 High-Grade/Grade 3 Bladder Cancer Treated with bacille Calmette-GuérinJournal of Urology, VOL. 199, NO. 2, (340-342), Online publication date: 1-Feb-2018.Narayan V, Adejoro O, Schwartz I, Ziegelmann M, Elliott S and Konety B (2017) The Prevalence and Impact of Urinary Marker Testing in Patients with Bladder CancerJournal of Urology, VOL. 199, NO. 1, (74-80), Online publication date: 1-Jan-2018.Chang S (2017) Re: Papillary Recurrence of Bladder Cancer at First Evaluation after Induction Bacillus Calmette-Guérin Therapy: Implication for Clinical Trial DesignJournal of Urology, VOL. 198, NO. 2, (255-255), Online publication date: 1-Aug-2017.Chang S (2017) Re: EORTC Nomograms and Risk Groups for Predicting Recurrence, Progression, and Disease-Specific and Overall Survival in Non-Muscle-Invasive Stage Ta-T1 Urothelial Bladder Cancer Patients Treated with 1-3 Years of Maintenance Bacillus Calmette-GuérinJournal of Urology, VOL. 198, NO. 1, (39-41), Online publication date: 1-Jul-2017.Chang S (2017) Re: Cytokine Panel for Response to Intravesical Therapy (CyPRIT): Nomogram of Changes in Urinary Cytokine Levels Predicts Patient Response to bacillus Calmette-GuérinJournal of Urology, VOL. 197, NO. 6, (1439-1440), Online publication date: 1-Jun-2017.Kavalieris L, O’Sullivan P, Frampton C, Guilford P, Darling D, Jacobson E, Suttie J, Raman J, Shariat S and Lotan Y (2016) Performance Characteristics of a Multigene Urine Biomarker Test for Monitoring for Recurrent Urothelial Carcinoma in a Multicenter StudyJournal of Urology, VOL. 197, NO. 6, (1419-1426), Online publication date: 1-Jun-2017.Chang S (2017) Re: Systematic Review and Individual Patient Data Meta-Analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy after Transurethral Resection with Transurethral Resection Alone in Patients with Stage pTa-pT1 Urothelial Carcinoma of the Bladder: Which Patients Benefit from the Instillation?Journal of Urology, VOL. 197, NO. 5, (1219-1219), Online publication date: 1-May-2017.Chang S (2017) Re: Multicenter Evaluation of the Role of UroVysion FISH Assay in Surveillance of Patients with Bladder Cancer: Does FISH Positivity Anticipate Recurrence?Journal of Urology, VOL. 197, NO. 4, (1003-1005), Online publication date: 1-Apr-2017.Chang S (2016) Re: Long-Term Outcome of Patients with Frequently Recurrent Non-Muscle-Invasive Bladder Carcinoma Treated with One Perioperative plus Four Weekly Instillations of Mitomycin C followed by Monthly bacillus Calmette-Guérin (BCG) or Alternating BCG and Interferon-α2b Instillations: Prospective Randomised FinnBladder-4 StudyJournal of Urology, VOL. 197, NO. 3 Part 1, (605-606), Online publication date: 1-Mar-2017.Lane G, Downs T, Soubra A, Rao A, Hemsley L, Laylan C, Shi F and Konety B (2016) Tolerability of Repeat Use of Blue Light Cystoscopy with Hexaminolevulinate for Patients with Urothelial Cell CarcinomaJournal of Urology, VOL. 197, NO. 3 Part 1, (596-601), Online publication date: 1-Mar-2017. Volume 196Issue 4October 2016Page: 1021-1029 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsdrug therapyurinary bladder neoplasmsimmunotherapycystectomyMetricsAuthor Information Sam S. Chang More articles by this author Stephen A. Boorjian More articles by this author Roger Chou More articles by this author Peter E. Clark More articles by this author Siamak Daneshmand More articles by this author Badrinath R. Konety More articles by this author Raj Pruthi More articles by this author Diane Z. Quale More articles by this author Chad R. Ritch More articles by this author John D. Seigne More articles by this author Eila Curlee Skinner More articles by this author Norm D. Smith More articles by this author James M. McKiernan More articles by this author Expand All Advertisement PDF downloadLoading ...