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

Chang, Sam S.; Boorjian, Stephen A.; Chou, Roger; Clark, Peter E.; Daneshmand, Siamak; Konety, Badrinath R.; Pruthi, Raj S.; Quale, Diane Zipursky; Ritch, Chad R.; Seigne, John D.; Skinner, Eila C.; Smith, Norm D.; McKiernan, James M.

doi:10.1016/j.juro.2016.06.049

Cited by 1,132 publications

(1,081 citation statements)

References 34 publications

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“…Involvement of prostatic tissue and presence of variant histology (VH) were commented on if found. Using the American/ Society of Urologic Oncology (SUO) and Canadian bladder cancer guidelines, 10,11 as well as our institutional guidelines of care, each case was assigned a tumour risk category with the initial pathological report and another one according to the review pathology report. Preferred management was matched to the proposed risk category.…”

Section: Methodsmentioning

confidence: 99%

Pathology review impacts clinical management of patients with T1‒T2 bladder cancer

Traboulsi

Brimo

Yang

et al. 2017

CUAJ

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Introduction: We sought to evaluate the contemporary role of a pathology review on management implications of patients with bladder cancer. Methods: A total of 98 consecutive specimens from transurethral resections in patients with suspected bladder tumours were reviewed at our institution by genitourinary pathologist. Patients were classified into risk groups according to pathology reports obtained before and after review. A management course was proposed according to local institutional practice patterns and main urological guidelines. Results: Overall, 34.7% of pathological reviews had significant changes associated with management implications, the majority of which were due to changes in risk category (and/or stage). On review pathology, 12 patients were recommended radical cystectomy instead of conservative management and two patients avoided radical cystectomy. Six patients initially staged as T1 and whose staging did not change after review had a proposed change in management in the form of early cystectomy as a treatment option, as they were deemed very high-risk secondary to high-risk features (such as carcinoma in situ or lymphovascular invasion found on review). Ten patients initially staged as T2 demonstrated high-risk features on review. Conclusions: Review by genitourinary pathologist remains important, as it defines more clearly the tumour risk category and influences the management of T1-T2 bladder cancer patients. A complete initial pathological report has the potential to further decrease the discrepancy between initial and review reports.

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Section: Methodsmentioning

confidence: 99%

Pathology review impacts clinical management of patients with T1‒T2 bladder cancer

Traboulsi

Brimo

Yang

et al. 2017

CUAJ

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“…Additionally, there is little evidence for adjuvant or neoadjuvant therapies in kidney cancer, limiting the possible treatment options for these patients, but as more therapies are approved for high-risk renal cell carcinoma the likelihood of change in these patients may increase. 13 Conversely, patients with bladder or prostate cancer have multiple treatment options and adjuvant therapies available to them likely resulting in a high rate of change in these patients 14,15 Representative examples of changes made in our study include bladder cancer patients who were determined to warrant medical therapy with Bacillus Calmette-Guerin therapy as opposed to surveillance following TURBT and patients with high risk pathologic features following…”

Section: Cuaj -Original Researchmentioning

confidence: 99%

Evaluating the impact of the genitourinary multidisciplinary tumour board: Should every cancer patient be discussed as standard of care?

Scarberry

Ponsky

Cherullo

et al. 2018

CUAJ

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Introduction: We sought to prospectively evaluate the effectiveness of the multidisciplinary tumour board (MTB) on altering treatment plans for genitourinary (GU) cancer patients. Methods: All GU cancer patients seen at our tertiary care hospital are discussed at MTB. We prospectively collected data on adult patients discussed over a continuous, 20-month period. Physicians completed a survey prior to MTB to document their opinion on the likelihood of change in their patient's treatment plan. Logistic regression was used to asses for factors associated with a change by the MTB, including patient age or sex, malignancy type, the predicted treatment plan, and the provider's years of experience or fellowship training. Results: A total of 321 cancer patients were included. Patients were primarily male (84.4%) with a median age of 67 (range 20-92) years old. Prostate (38.9%), bladder (31.8%), and kidney cancer (19.6%) were the most common malignancies discussed. A change in management plan following MTB was observed in 57 (17.8%) patients. The physician predicted a likely change in six (10.5%) of these patients. Multivariate logistic regression did not determine physician prediction to be associated with treatment plan change, and the only significant variable identified was a plan to discuss multiple treatment options with a patient (odds ratio 2.46; 95% confidence interval 1.09-9.54). Conclusions: Routine discussion of all urologic oncology cases at MTB led to a change in treatment plan in 17.8% of patients. Physicians cannot reliably predict which patients have their CUAJ -Original ResearchScarberry et al Genitourinary multidisciplinary tumour board treatment plan altered. Selectively choosing patients to be presented likely undervalues the impact of a multidisciplinary approach to care.

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“…A non-invasive assay would provide significant benefits for patient comfort, with urine as an ideal sample for bladder cancer diagnosis and follow-ups due to the ease of obtaining patient samples in a non-invasive manner [9]. Based on established guidelines, it is currently not recommended to test urinary biomarkers in place of cystoscopy [16,17,62].…”

Section: Invasive Techniquesmentioning

confidence: 99%

Microdevices for Non-Invasive Detection of Bladder Cancer

et al. 2017

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Bladder cancer holds the record for the highest lifetime cost on a per-patient basis. This is due to high recurrence rates, which necessitate invasive and costly long-term evaluation methods such as cystoscopy and imaging. Microfluidics is emerging as an important approach to contribute to initial diagnosis and follow-up, by enabling the precise manipulation of biological samples. Specifically, microdevices have been used for the isolation of cells or genetic material from blood samples, sparking significant interest as a versatile platform for non-invasive bladder cancer detection with voided urine. In this review, we revisit the methods of bladder cancer detection and describe various types of markers currently used for evaluation. We detail cutting-edge technologies and evaluate their merits in the detection, screening, and diagnosis of bladder cancer. Advantages of microscale devices over standard methods of detection, as well as their limitations, are provided. We conclude with a discussion of criteria for guiding microdevice development that could deepen our understanding of prognoses at the level of individual patients and the underlying biology of bladder cancer development. Collectively, the development and widespread application of improved microfluidic devices for bladder cancer could drive treatment breakthroughs and establish widespread, tangible outcomes on patients' long-term survival.

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

Cited by 1,132 publications

References 34 publications

Pathology review impacts clinical management of patients with T1‒T2 bladder cancer

Pathology review impacts clinical management of patients with T1‒T2 bladder cancer

Evaluating the impact of the genitourinary multidisciplinary tumour board: Should every cancer patient be discussed as standard of care?

Microdevices for Non-Invasive Detection of Bladder Cancer

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