Managing noninvasive recurrences after definitive treatment for muscle-invasive bladder cancer or high-grade upper tract urothelial carcinoma

Abstract

Limited progress has been achieved in differentiating management of recurrent urothelial carcinoma from the treatment of primary urothelial carcinoma. However, there may be an increasing role for endoscopic and organ conserving therapies for carefully selected patients with recurrent noninvasive urothelial carcinoma. Identifying those at risk for early recurrence and early diagnosis of recurrence may be the most beneficial future strategies. The treatment regimen for noninvasive bladder recurrence after radical nephroureterectomy for upper tract urothelial carcinoma should include intravesical chemotherapy or Bacillus Calmette-Guerin to prevent further bladder recurrence or tumor progression. We do not advocate diversion sparing techniques for local recurrence after radical cystectomy. Metastasectomy for distant/metastatic urothelial carcinoma recurrence represents a promising area of future study.

Intravesical Recurrence After Radical Nephroureterectomy of Upper Urinary Tract Urothelial Carcinoma: A Large Population-Based Investigation of Clinicopathologic Characteristics and Survival Outcomes

“…Several studies have assessed clinicopathologic factors linked to IVR and several risk factors including T stage, multifocality, and the use of diagnostic ureteroscopy have been identified (6,13). Management of subsequent bladder cancer after RNU for UTUC is identical to the current treatment strategy for any primary BC (3,14). Based on NCCN and EAU guidelines for bladder cancer, TURBT is the standard treatment for NMIBC and radical cystectomy is the standard treatment for MIBC.…”

Treatment approaches for FGFR-altered urothelial carcinoma: targeted therapies and immunotherapy

“…Muscle-invasive UC management is dictated by a patient’s co-morbidities and ability to tolerate either chemotherapy and/or surgery with treatment modalities including: cystectomy with or without neoadjuvant chemotherapy and adjuvant nivolumab, tri-modality therapy with TURBT followed by chemotherapy plus radiation, or radiation therapy or TURBT alone ( 7 ). Despite treatment, approximately half of individuals with muscle-invasive disease may experience recurrence ( 8 ). Recurrence and metastatic UC is generally treated with systemic therapies including chemotherapy, immunotherapy, or antibody drug conjugates.…”

Transuretero Ureterostomy: Current State of the Problem and its Place in Oncological Urology

“…Конечно же, существуют наиболее используемые варианты, к которым следует отнести ортотопический резервуар по Studer, гетеротопическую влажную кутанеоилеостому по Briker, и у соматически тяжелой категории пациентов предпочтительным вариантом отведения мочи является уретерокутанеостомия [22,23,24,25]. Наличие современных средств ухода обеспечивает стомированным пациентам хорошую социальную адаптацию, а инконтинентная уроилеостома по Briker снижает риск осложнений, связанных с длительным пребыванием мочи в сегменте кишки и потерей почечной функции [19].…”