¿Es necesario resecar siempre las recidivas de los tumores vesicales superficiales en el momento del diagnostico?: comunicación preliminar

Cáceres, P. Martínez; Arroyo, Jorge G.; Toniolo, G

doi:10.4321/s0210-48062005000600006

Cited by 2 publications

(4 citation statements)

References 1 publication

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“…Study/year a Soloway 2003 [32] Martı´ı´nez C aceres 2005 [36] Gofrit 2006 [38] Pruthi 2008 [33] Hernandez 2016 [34] Lozano 2019 [35] Contieri surgical risk due to comorbidities such as Charlson Comorbidity Index >6), AS might be a feasible strategy [43]. After a median time under AS of 13 months, none of the 24 patients experienced disease progression to MIBC and almost 46% were still under AS [43].…”

Section: Characteristics Of Studies On As In Nmibcmentioning

confidence: 99%

“…All reported the pathological tumor stage and grade at inclusion but not all provided details on the exact inclusion criteria regarding tumor stage. When reported, studies included pTa tumors, with only one study excluding pT1-NMIBC (Table 1) [31 ▪ ,32–36,37 ▪▪ ,38]. Indeed, the pathological tumor stages to be included in AS remain debated.…”

Section: Patient Selection For Active Surveillancementioning

confidence: 99%

“…There is no widely accepted cut-off regarding the maximal tumor size that could be included in AS. Among previous studies, inclusion criteria were ‘small’ tumors, tumors <10 mm, and some authors did not report any tumor size cut-off [31 ▪ ,32,33,35,36]. Overall, the evidence for a differential risk of progression based on tumor size in Ta tumors is negligible [52].…”

Section: Patient Selection For Active Surveillancementioning

confidence: 99%

“…The precise definition of AS failure is also a surrogate for establishing a clear AS protocol. Failure criteria for AS were commonly defined in the literature as an increase in the number or size of the tumor, and/or presence of any bothersome symptoms such as hematuria, and/or positive UC (Table 1) [32,34–36,37 ▪▪ ,38]. With a median follow-up of 38 months, approximately 2/3 of patients stopped AS [31 ▪ ,37 ▪▪ ,58].…”

Section: Definition Of As Failurementioning

confidence: 99%

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Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?

Deimling

Pallauf

Bianchi

et al. 2022

Current Opinion in Urology

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Purpose of reviewThis review aims to analyze the current place of active surveillance (AS) in non-muscle-invasive bladder cancer (NMIBC).Recent findingsA growing body of evidence suggests that AS protocols for pTa low-grade (TaLG) NMIBC are safe and feasible. However, current guidelines have not implemented AS due to a lack of high-quality data. Available studies included pTa tumors, with only one study excluding pT1-NMIBC. Inclusion/exclusion criteria were heterogeneously defined based on tumor volume, number of tumors, carcinoma in situ (CIS), or high-grade (HG) NMIBC. Tumor volume <10 mm and <5 lesions were used as cut-offs. Positive urinary cytology (UC) or cancer-related symptoms precluded inclusion. Surveillance within the first year consisted of quarterly cystoscopy. AS stopped upon the presence of cancer-related symptoms, change in tumor morphology, positive UC, or patient's request. With a median time on AS of 16 months, two-thirds of the patients failed AS. Progression to muscle-invasive bladder cancer (MIBC) was rare and occurred only in patients with pT1-NIMBC at inclusion.SummaryAS in NMIBC is an attractive concept in the era of personalized medicine, but strong evidence is still awaited. A more precise definition of patient inclusion, follow-up, and failure criteria is required to improve its implementation in daily clinical practice.

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Section: Characteristics Of Studies On As In Nmibcmentioning

confidence: 99%

Section: Patient Selection For Active Surveillancementioning

confidence: 99%

Section: Patient Selection For Active Surveillancementioning

confidence: 99%

Section: Definition Of As Failurementioning

confidence: 99%

See 2 more Smart Citations

Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?

Deimling

Pallauf

Bianchi

et al. 2022

Current Opinion in Urology

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Active surveillance for non-muscle invasive bladder cancer

Marcq

Hénon

Ouzaïd

et al. 2019

Transl. Androl. Urol

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Most of low grade (LG) bladder tumors will experience disease recurrence and very few of them (<2%) will experience disease progression. Therefore active surveillance (AS) for LG non-muscle invasive bladder cancer (NMIBC) has emerged. The goal of our study was to provide a literature review of AS for LG NMIBC including inclusion criteria, modalities and oncological outcomes. We conducted a systematic review (registered in PROSPERO: CRD42018102935) using MEDLINE and EMBASE between June 2018 and August 2018 with the following terms: LG, NMIBC, AS, urothelial neoplasm. Overall, 6 studies that reached our scope of review were included cumulating 403 patients with 2 prospective trials. Inclusion criteria were: recurrent LG (G1 and G2) Ta or T1 NMIBC, with a negative cytology, a low volume (<10 mm) and low number (<5) of tumors. Cystoscopy every 3 months during the first 2 years and every 6 months afterwards were required. AS dropout criteria were presence of tumor-related symptoms, a positive cytology, a modification of tumor morphology or size and patient’s request. Pooled data showed an overall 65% reclassification rate where 15% of patients were reclassified based on grade and 10% on stage with a median follow-up of 32 months (IQR, 24–42 months). Only one study reported on progression to MIBC in 4 patients out of 186 (2%). Most of patients enrolled in an AS protocol for recurrent LG NMIBC will undergo a TURBT eventually. Many patients may be eligible to this therapeutic approach but current knowledge does not support its use in daily practice outside of a clinical trial.

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¿Es necesario resecar siempre las recidivas de los tumores vesicales superficiales en el momento del diagnostico?: comunicación preliminar

Cited by 2 publications

References 1 publication

Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?

Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?

Active surveillance for non-muscle invasive bladder cancer

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