Precise diagnosis and treatment of non-muscle invasive bladder cancer - A clinical perspective

Abstract

According to the guidelines, transurethral resection of bladder tumor (TURBT) followed by intravesical therapy remains the standard strategy for the management of non-muscle invasive bladder cancer (NMIBC). However, even if patients receive standard strategy, the risk of postoperative recurrence and progression is high. From the clinical perspective, the standard strategy needs to be optimized and improved. Compared to conventional TURBT, the technique of en bloc resection of bladder tumor (ERBT) removes the tumor tissue in one piece, thus following the principles of cancer surgery. Meanwhile, the integrity and spatial orientation of tumor tissue is protected during the operation, which is helpful for pathologists to make accurate histopathological analysis. Then, urologists can make a postoperative individualized treatment plan based on the patient’s clinical characteristics and histopathological results. To date, there is no strong evidence that NMIBC patients treated with ERBT achieve better oncological prognosis, which indicates that ERBT alone does not yet improve patient outcomes. With the development of enhanced imaging technology and proteogenomics technology, en bloc resection combined with these technologies will make it possible to achieve precise diagnosis and treatment of bladder cancer. In this review, the authors analyze the current existing shortcomings of en bloc resection and points out its future direction, in order to promote continuous optimization of the management strategy of bladder cancer.

Perfusion drugs for non‑muscle invasive bladder cancer (Review)

“…When gemcitabine enters the cell, it is activated by deoxycytidine kinase and converted into gemcitabine diphosphate and gemcitabine triphosphate in the cell (12). Among them, Gemcitabine diphosphate can promote the competitive binding of Gemcitabine to DNA through a synergistic effect, preventing further synthesis of DNA to exert its antitumor effect (11,13).…”

The role of E3 ubiquitin ligases and deubiquitinases in bladder cancer development and immunotherapy

“…In addition, some risk factors, such as chemicals and aromatic amines, arsenic contamination and aluminum, could increase the bladder cancer development. The treatments of bladder cancer often include endoscopic resection, chemotherapy, radiation, intravesical immunotherapy and combination therapy (5)(6)(7). The gold standard therapy for MIBC was chemotherapy and radical cystectomy.…”