UROLOGICAL ONCOLOGY

Guidelines on TaT1 (Non-muscle Invasive) Bladder Cancer
Oosterlinck W, van der Meijden A, Sylvester R, Bohle A, Rintala E, Solsona Narvón E, Lobel B
European Association of Urology
http://www.uroweb.org/files/uploaded_files/guidelines/05%20TaT1%20Bladder%20Cancer.pdf

     No abstract avilable

• Editorial Comment
  These guideline represent and evolutional development from the “old” EAU bladder cancer guidelines, which were well received worldwide. They incorporate recommendations for such major steps in superficial bladder cancer treatment as postoperative single shot instillation with chemotherapy and maintenance therapy with BCG.
  The most important information, which led to these steps forward, came from recently published metaanalyses, which were prepared in close cooperation predominantly from members of the guidelines group.
  Specifically, the following changes appear as of highest importance and are commented below. Guidelines for superficial and invasive bladder cancer are generated from different groups and are distinct.
  Use of histological classification - However, until the 2004 WHO classification has been validated by more clinical trials, tumors should be graded according to both the 1973 and the 2003 WHO classification.
  Fluorescence cystoscopy - This investigational method has not yet been implemented on a regular basis in daily practice.
  Second resection is recommended in most intermediate and all high-risk tumors.
  Single-shot postoperative instillation of chemotherapy is strongly recommended.
  Intravesical BCG is superior to intravesical chemotherapy in reducing recurrences and is the only drug to interfere with progression of SBC. BCG immunotherapy is indicated in intermediate risk and high-risk bladder cancer. The use of maintenance therapy of at least 1 year is strongly recommended.
  An algorithm for predicting tumor recurrence and progression is extensively provided in these guidelines.

Dr. Andreas Bohle
Professor of Urology
HELIOS Agnes Karll Hospital
Bad Schwartau, Germany