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Urinary Bladder Neoplasms HELP
Based on 13,539 articles since 2008
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These are the 13539 published articles about Urinary Bladder Neoplasms that originated from Worldwide during 2008-2017.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline [Radiotherapy of bladder cancer]. 2016

Riou, O / Chauvet, B / Lagrange, J-L / Martin, P / Llacer Moscardo, C / Charissoux, M / Lauche, O / Aillères, N / Fenoglietto, P / Azria, D. ·Département de cancérologie radiothérapie, ICM-Val d'Aurelle, rue de la Croix-Verte, 34298 Montpellier, France. Electronic address: olivier.riou@icm.unicancer.fr. · Service de radiothérapie, institut Sainte-Catherine, BP 846, 84082 Avignon cedex 2, France. · Université Paris Est-Créteil, avenue du Général-de-Gaulle, 94010 Créteil cedex, France; Service de radiothérapie, hôpital Henri-Mondor, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France. · Service de radiothérapie, centre Joliot-Curie, route de Desvres, 62280 Saint-Martin-Boulogne, France. · Département de cancérologie radiothérapie, ICM-Val d'Aurelle, rue de la Croix-Verte, 34298 Montpellier, France. ·Cancer Radiother · Pubmed #27521030.

ABSTRACT: Surgery (radical cystectomy) is the standard treatment of muscle-invasive bladder cancer. Radiochemotherapy has risen as an alternative treatment option to surgery as part as organ-sparing combined modality treatment or for patients unfit for surgery. Radiochemotherapy achieves 5-year bladder intact survival of 40 to 65% and 5-year overall survival of 40 to 50% with excellent quality of life. This article introduces the French recommendations for radiotherapy of bladder cancer: indications, exams, technique, dosimetry, delivery and image guidance.

2 Guideline Singapore Cancer Network (SCAN) Guidelines for Neoadjuvant and Adjuvant Chemotherapy for Muscle-invasive Bladder Cancer. 2015

Anonymous711041. · ·Ann Acad Med Singapore · Pubmed #26763059.

ABSTRACT: INTRODUCTION: The SCAN genitourinary cancer workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for neoadjuvant and adjuvant chemotherapy for muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting. RESULTS: Three international guidelines were evaluated- those developed by the National Comprehensive Cancer Network (2014), the European Society of Medical Oncology (2011) and the European Association of Urology (2013). Recommendations on the use of neoadjuvant and adjuvant chemotherapy in MIBC were developed. CONCLUSION: These adapted guidelines form the SCAN Guidelines 2015 for neoadjuvant and adjuvant chemotherapy in MIBC.

3 Guideline European Association of Urology Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma: 2015 Update. 2015

Rouprêt, Morgan / Babjuk, Marko / Compérat, Eva / Zigeuner, Richard / Sylvester, Richard J / Burger, Maximilian / Cowan, Nigel C / Böhle, Andreas / Van Rhijn, Bas W G / Kaasinen, Eero / Palou, Joan / Shariat, Shahrokh F. ·Department of Urology, Hospital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie, Institut Universitaire de Cancérologie, Paris, France. Electronic address: morgan.roupret@aphp.fr. · Department of Urology, Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic. · Department of Pathology, Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie, Institut Universitaire de Cancérologie, Paris, France. · Department of Urology, Medizinische Universität Graz, Graz, Austria. · EAU Guidelines Office Board, European Association of Urology, The Netherlands. · Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany. · Department of Radiology, Queen Alexandra Hospital, Portsmouth, UK. · Helios Agnes Karll Krankenhaus, Schwartau, Germany. · Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. · Department of Surgery, Hyvinkää Hospital, Hyvinkää, Finland. · Department of Urology, Universitat Autònoma de Barcelona-Fundació Puigvert, Barcelona, Spain. · Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, Weill Medical College of Cornell University, New York, NY, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. ·Eur Urol · Pubmed #26188393.

ABSTRACT: CONTEXT: The European Association of Urology (EAU) guidelines panel on upper urinary tract urothelial cell carcinoma (UTUC) has prepared updated guidelines to aid clinicians in the current evidence-based management of UTUC and to incorporate recommendations into clinical practice. OBJECTIVE: To provide a brief overview of the EAU guidelines on UTUC as an aid to clinicians. EVIDENCE ACQUISITION: The recommendations provided in the current guidelines are based on a thorough review of available UTUC guidelines and articles identified following a systematic search of Medline. Data on urothelial malignancies and UTUC were searched using these keywords: urinary tract cancer; urothelial carcinomas; upper urinary tract, carcinoma; renal pelvis; ureter; bladder cancer; chemotherapy; nephroureterectomy; adjuvant treatment; instillation; neoadjuvant treatment; recurrence; risk factors; and survival. References were weighted by a panel of experts. EVIDENCE SYNTHESIS: Due to the rarity of UTUC, there are insufficient data to provide strong recommendations (ie, grade A). However, the results of recent multicentre studies are now available, and there is a growing interest in UTUC. The 2009 TNM classification is recommended. Recommendations are given for diagnosis and risk stratification as well as radical and conservative treatment, and prognostic factors are discussed. A single postoperative dose of intravesical mitomycin after nephroureterectomy reduces the risk of bladder tumour recurrence. Recommendations are also provided for patient follow-up after different therapeutic strategies. CONCLUSIONS: These guidelines contain information on the management of individual patients according to a current standardised approach. Urologists should take into account the specific clinical characteristics of each patient when determining the optimal treatment regimen, based on the proposed risk stratification of these tumours. PATIENT SUMMARY: Urothelial carcinoma of the upper urinary tract is rare, but because 60% of these tumours are invasive at diagnosis, an appropriate diagnosis is most important. A number of known risk factors exist.

4 Guideline Robot-assisted radical cystectomy and urinary diversion: technical recommendations from the Pasadena Consensus Panel. 2015

Chan, Kevin G / Guru, Khurshid / Wiklund, Peter / Catto, James / Yuh, Bertram / Novara, Giacomo / Murphy, Declan G / Al-Tartir, Tareq / Collins, Justin W / Zhumkhawala, Ali / Wilson, Timothy G / Anonymous3420818. ·City of Hope Cancer Center, Duarte, CA, USA. Electronic address: kchan@coh.org. · Roswell Park Cancer Institute, Buffalo, NY, USA. · Karolinska Institute, Stockholm, Sweden. · University of Sheffield, Sheffield, UK. · City of Hope Cancer Center, Duarte, CA, USA. · University of Padua, Padua, Italy. · Peter MacCallum Cancer Centre, Melbourne, Australia. · ·Eur Urol · Pubmed #25595099.

ABSTRACT: BACKGROUND: The technique of robot-assisted radical cystectomy (RARC) has evolved significantly since its inception >10 yr ago. Several high-volume centers have reported standardized techniques with refinements and subsequent outcomes. OBJECTIVE: To review all existing literature on RARC and urinary diversion techniques and summarize key points that may affect oncologic, surgical, and functional outcomes. DESIGN, SETTING, AND PARTICIPANTS: The Pasadena Consensus Panel on RARC and urinary reconstruction convened May 3-4, 2014, to review the existing peer-reviewed literature and create recommendations for best practice. The panel consisted of experts in open radical cystectomy and RARC. No commercial support was received. SURGICAL PROCEDURE: The consensus panel extensively reviewed the surgical technique of RARC in men and women, extended pelvic lymph node dissection, extracorporeal urinary diversion, and intracorporeal urinary diversion. Critical aspects of the technique are described. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Preoperative, operative, and postoperative parameters from the largest and most contemporary RARC series, stratified by urinary diversion technique, are presented. RESULTS AND LIMITATIONS: Preoperative, operative, and postoperative measures of RARC technique adhere closely to the standards established in open surgery. CONCLUSIONS: Refinement of techniques for RARC and urinary diversion over the past 10 yr has made it safe, reproducible, and oncologically sound. PATIENT SUMMARY: We summarize the critical aspects of surgical techniques reviewed at the Pasadena international consensus meeting on RARC and urinary reconstruction. Preoperative, operative, and postoperative measures of RARC technique adhere closely to the standards established in open surgery.

5 Guideline Best practices in robot-assisted radical cystectomy and urinary reconstruction: recommendations of the Pasadena Consensus Panel. 2015

Wilson, Timothy G / Guru, Khurshid / Rosen, Raymond C / Wiklund, Peter / Annerstedt, Magnus / Bochner, Bernard H / Chan, Kevin G / Montorsi, Francesco / Mottrie, Alexandre / Murphy, Declan / Novara, Giacomo / Peabody, James O / Palou Redorta, Joan / Skinner, Eila C / Thalmann, George / Stenzl, Arnulf / Yuh, Bertram / Catto, James / Anonymous650818. ·City of Hope Cancer Center, Duarte, CA, USA. Electronic address: twilson@coh.org. · Roswell Park Cancer Institute, Buffalo, NY, USA. · New England Research Institutes, Inc., Watertown, MA, USA. · Karolinska Institutet, Stockholm, Sweden. · Urology STHLM, Stockholm, Sweden. · Memorial Sloan-Kettering Cancer Center, New York, NY, USA. · City of Hope Cancer Center, Duarte, CA, USA. · University Vita-Salute San Raffaele, Milan, Italy. · O.L.V. Clinic, Aalst, Belgium. · Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. · University of Padua, Padua, Italy. · Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA. · Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain. · Stanford University, Stanford, CA, USA. · University of Bern, Bern, Switzerland. · Eberhard Karls University of Tübingen, Tubingen, Germany. · University of Sheffield, Sheffield, UK. · ·Eur Urol · Pubmed #25582930.

ABSTRACT: CONTEXT: Robot-assisted surgery is increasingly used for radical cystectomy (RC) and urinary reconstruction. Sufficient data have accumulated to allow evidence-based consensus on key issues such as perioperative management, comparative effectiveness on surgical complications, and oncologic short- to midterm outcomes. OBJECTIVE: A 2-d conference of experts on RC and urinary reconstruction was organized in Pasadena, California, and the City of Hope Cancer Center in Duarte, California, to systematically review existing peer-reviewed literature on robot-assisted RC (RARC), extended lymphadenectomy, and urinary reconstruction. No commercial support was obtained for the conference. EVIDENCE ACQUISITION: A systematic review of the literature was performed in agreement with the PRISMA statement. EVIDENCE SYNTHESIS: Systematic literature reviews and individual presentations were discussed, and consensus on all key issues was obtained. Most operative, intermediate-term oncologic, functional, and complication outcomes are similar between open RC (ORC) and RARC. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC generally requires longer operative time than ORC, particularly with intracorporeal reconstruction. Robotic assistance provides ergonomic value for surgeons. Surgeon experience and institutional volume strongly predict favorable outcomes for either open or robotic techniques. CONCLUSIONS: RARC appears to be similar to ORC in terms of operative, pathologic, intermediate-term oncologic, complication, and most functional outcomes. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC can be more expensive than ORC, although high procedural volume may attenuate this difference. PATIENT SUMMARY: Robot-assisted radical cystectomy (RARC) is an alternative to open surgery for patients with bladder cancer who require removal of their bladder and reconstruction of their urinary tract. RARC appears to be similar to open surgery for most important outcomes such as the rate of complications and intermediate-term cancer-specific survival. Although RARC has some ergonomic advantages for surgeons and may result in less blood loss during surgery, it is more time consuming and may be more expensive than open surgery.

6 Guideline Update for the practicing pathologist: The International Consultation On Urologic Disease-European association of urology consultation on bladder cancer. 2015

Amin, Mahul B / Smith, Steven C / Reuter, Victor E / Epstein, Jonathan I / Grignon, David J / Hansel, Donna E / Lin, Oscar / McKenney, Jesse K / Montironi, Rodolfo / Paner, Gladell P / Al-Ahmadie, Hikmat A / Algaba, Ferran / Ali, Syed / Alvarado-Cabrero, Isabel / Bubendorf, Lukas / Cheng, Liang / Cheville, John C / Kristiansen, Glen / Cote, Richard J / Delahunt, Brett / Eble, John N / Genega, Elizabeth M / Gulmann, Christian / Hartmann, Arndt / Langner, Cord / Lopez-Beltran, Antonio / Magi-Galluzzi, Cristina / Merce, Jorda / Netto, George J / Oliva, Esther / Rao, Priya / Ro, Jae Y / Srigley, John R / Tickoo, Satish K / Tsuzuki, Toyonori / Umar, Saleem A / Van der Kwast, Theo / Young, Robert H / Soloway, Mark S. ·Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. · Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, USA. · Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA. · Department of Pathology, University of California San Diego, San Diego, CA, USA. · Department of Pathology, Cleveland Clinic Foundation, Cleveland, OH, USA. · Section of Pathological Anatomy, Polytechnic University of Medicine, United Hospitals, Ancona, Italy. · Department of Pathology, University of Chicago, Chicago, IL, USA. · Pathology Section, Fundacio Puigvert, Universitat Autónoma de Barcelona, Barcelona, Spain. · Department of Pathology, Mexican Oncology Hospital, Mexico City, Mexico. · Institute of Pathology, University Hospital Basel, Basel, Switzerland. · Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA. · Institute of Pathology, University Hospital Bonn, Bonn, Germany. · Department of Pathology, University of Miami Miller School of Medicine, Miami, FL, USA. · Department of Pathology, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. · Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA, USA. · Department of Pathology, Beaumont Hospital, Dublin, Ireland. · Institute of Pathology, University Erlangen-Nürnberg, Erlangen, Germany. · Institute of Pathology, Medical University Graz, Graz, Austria. · Unit of Anatomical Pathology, Cordoba University Medical School, Faculty of Medicine, Cordoba, Spain. · James Homer Wright Pathology Laboratories, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. · Department of Pathology and Genomic Medicine, The Methodist Hospital Physician Organization, Weill Cornell Medical College of Cornell University, Houston, TX, USA. · Department Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada. · Department of Pathology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan. · Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA. ·Mod Pathol · Pubmed #25412849.

ABSTRACT: The International Consultations on Urological Diseases are international consensus meetings, supported by the World Health Organization and the Union Internationale Contre le Cancer, which have occurred since 1981. Each consultation has the goal of convening experts to review data and provide evidence-based recommendations to improve practice. In 2012, the selected subject was bladder cancer, a disease which remains a major public health problem with little improvement in many years. The proceedings of the 2nd International Consultation on Bladder Cancer, which included a 'Pathology of Bladder Cancer Work Group,' have recently been published; herein, we provide a summary of developments and consensus relevant to the practicing pathologist. Although the published proceedings have tackled a comprehensive set of issues regarding the pathology of bladder cancer, this update summarizes the recommendations regarding selected issues for the practicing pathologist. These include guidelines for classification and grading of urothelial neoplasia, with particular emphasis on the approach to inverted lesions, the handling of incipient papillary lesions frequently seen during surveillance of bladder cancer patients, descriptions of newer variants, and terminology for urine cytology reporting.

7 Guideline Bladder cancer: ESMO Practice Guidelines for diagnosis, treatment and follow-up. 2014

Bellmunt, J / Orsola, A / Leow, J J / Wiegel, T / De Santis, M / Horwich, A / Anonymous6870802. ·Department of Medical Oncology, University Hospital del Mar-IMIM, Barcelona, Spain Bladder Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, USA. · Department of Urology, Vall d'Hebron University Hospital, Barcelona, Spain. · Department of Radio Oncology, University Hospital Ulm, Ulm, Germany. · Ludwig Boltzmann Institute for Applied Cancer Research, Kaiser Franz Josef- Spital, Vienna, Austria. · Institute of Cancer Research and Royal Marsden Hospital, Sutton, UK. · ·Ann Oncol · Pubmed #25096609.

ABSTRACT: -- No abstract --

8 Guideline Clinical and cost effectiveness of hexaminolevulinate-guided blue-light cystoscopy: evidence review and updated expert recommendations. 2014

Witjes, J Alfred / Babjuk, Marek / Gontero, Paolo / Jacqmin, Didier / Karl, Alexander / Kruck, Stephan / Mariappan, Paramananthan / Palou Redorta, Juan / Stenzl, Arnulf / van Velthoven, Roland / Zaak, Dirk. ·Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: fred.witjes@radboudumc.nl. · Department of Urology, Motol Hospital, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic. · Department of Urology, San Giovanni Battista Hospital, University of Turin, Turin, Italy. · Department of Urology, Strasbourg University Hospital, Strasbourg, France. · Department of Urology, Ludwig Maximilians University, Munich, Germany. · Department of Urology, Eberhard Karls University, Tübingen, Germany. · Department of Urology, Western General Hospital, Edinburgh, UK. · Urologic Oncology Unit, Department of Urology, Puigvert Foundation, Barcelona, Spain. · Department of Urology, Jules Bordet Institute, Brussels, Belgium. · Department of Urology, Traunstein Hospital, Traunstein, Germany. ·Eur Urol · Pubmed #25001887.

ABSTRACT: CONTEXT: Non-muscle-invasive bladder cancer (NMIBC) is associated with a high recurrence risk, partly because of the persistence of lesions following transurethral resection of bladder tumour (TURBT) due to the presence of multiple lesions and the difficulty in identifying the exact extent and location of tumours using standard white-light cystoscopy (WLC). Hexaminolevulinate (HAL) is an optical-imaging agent used with blue-light cystoscopy (BLC) in NMIBC diagnosis. Increasing evidence from long-term follow-up confirms the benefits of BLC over WLC in terms of increased detection and reduced recurrence rates. OBJECTIVE: To provide updated expert guidance on the optimal use of HAL-guided cystoscopy in clinical practice to improve management of patients with NMIBC, based on a review of the most recent data on clinical and cost effectiveness and expert input. EVIDENCE ACQUISITION: PubMed and conference searches, supplemented by personal experience. EVIDENCE SYNTHESIS: Based on published data, it is recommended that BLC be used for all patients at initial TURBT to increase lesion detection and improve resection quality, thereby reducing recurrence and improving outcomes for patients. BLC is particularly useful in patients with abnormal urine cytology but no evidence of lesions on WLC, as it can detect carcinoma in situ that is difficult to visualise on WLC. In addition, personal experience of the authors indicates that HAL-guided BLC can be used as part of routine inpatient cystoscopic assessment following initial TURBT to confirm the efficacy of treatment and to identify any previously missed or recurrent tumours. Health economic modelling indicates that the use of HAL to assist primary TURBT is no more expensive than WLC alone and will result in improved quality-adjusted life-years and reduced costs over time. CONCLUSIONS: HAL-guided BLC is a clinically effective and cost-effective tool for improving NMIBC detection and management, thereby reducing the burden of disease for patients and the health care system. PATIENT SUMMARY: Blue-light cystoscopy (BLC) helps the urologist identify bladder tumours that may be difficult to see using standard white-light cystoscopy (WLC). As a result, the amount of tumour that is surgically removed is increased, and the risk of tumour recurrence is reduced. Although use of BLC means that the initial operation costs more than it would if only WLC were used, over time the total costs of managing bladder cancer are reduced because patients do not need as many additional operations for recurrent tumours.

9 Guideline EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. 2014

Witjes, J Alfred / Compérat, Eva / Cowan, Nigel C / De Santis, Maria / Gakis, Georgios / Lebret, Thierry / Ribal, Maria J / Van der Heijden, Antoine G / Sherif, Amir / Anonymous1940780. ·Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: f.witjes@uro.umcn.nl. · Department of Pathology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. · Department of Radiology, The Manor Hospital, Oxford, UK. · 3rd Medical Department and ACR-ITR and LBI-ACR Vienna-CTO, Kaiser Franz Josef Spital, Vienna, Austria. · Department of Urology, Eberhard-Karls-University Tuebingen, Tuebingen, Germany. · Hôpital Foch, Department of Urology, University of Versailles-Saint-Quentin-en-Yvelines, Suresnes, France. · Uro-Oncology Unit, Urology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain. · Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. · Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden. · ·Eur Urol · Pubmed #24373477.

ABSTRACT: CONTEXT: The European Association of Urology (EAU) guidelines panel on Muscle-invasive and Metastatic bladder cancer (BCa) updates its guidelines yearly. This updated summary provides a synthesis of the 2013 guidelines document, with emphasis on the latest developments. OBJECTIVE: To provide graded recommendations on the diagnosis and treatment of patients with muscle-invasive BCa (MIBC), linked to a level of evidence. EVIDENCE ACQUISITION: For each section of the guidelines, comprehensive literature searches covering the past 10 yr in several databases were conducted, scanned, reviewed, and discussed both within the panel and with external experts. The final results are reflected in the recommendations provided. EVIDENCE SYNTHESIS: Smoking and work-related carcinogens remain the most important risk factors for BCa. Computed tomography (CT) and magnetic resonance imaging can be used for staging, although CT is preferred for pulmonary evaluation. Open radical cystectomy with an extended lymph node dissection (LND) remains the treatment of choice for treatment failures in non-MIBC and T2-T4aN0M0 BCa. For well-informed, well-selected, and compliant patients, however, multimodality treatment could be offered as an alternative, especially if cystectomy is not an option. Comorbidity, not age, should be used when deciding on radical cystectomy. Patients should be encouraged to actively participate in the decision-making process, and a continent urinary diversion should be offered to all patients unless there are specific contraindications. For fit patients, cisplatinum-based neoadjuvant chemotherapy should always be discussed, since it improves overall survival. For patients with metastatic disease, cisplatin-containing combination chemotherapy is recommended. For unfit patients, carboplatin combination chemotherapy or single agents can be used. CONCLUSIONS: This 2013 EAU Muscle-invasive and Metastatic BCa guidelines updated summary aims to increase the quality of care and outcome for patients with muscle-invasive or metastatic BCa. PATIENT SUMMARY: In this paper we update the EAU guidelines on Muscle-invasive and Metastatic bladder cancer. We recommend that chemotherapy be administered before radical treatment and that bladder removal be the standard of care for disease confined to the bladder.

10 Guideline [CCAFU Recommendations 2013: Bladder carcinoma]. 2013

Pfister, C / Roupret, M / Neuzillet, Y / Larré, S / Pignot, G / Quintens, H / Houedé, N / Compérat, E / Colin, P / Roy, C / Davin, J-L / Guy, L / Irani, J / Lebret, T / Coloby, P / Soulié, M / Anonymous6190783. · · Membres expert du sous-comité vessie. ·Prog Urol · Pubmed #24485286.

ABSTRACT: INTRODUCTION: The objective was to update the guidelines of the French Urological Association Cancer Committee for non invasive (NMIBC) and invasive bladder cancer (MIBC). METHODS: A Medline search was performed between 2010 and 2013, as regards diagnosis, options of treatment and follow-up of bladder cancer, to evaluate different references with levels of evidence. RESULTS: Diagnosis of NMIBC (Ta, T1, CIS) depends on cystoscopy and complete deep resection of the tumour. The use of fluorescence and a second-look indication are essential to improve initial diagnosis. Risks of both recurrence and progression can be estimated using the EORTC score. A stratification of patients into low, intermediate and high groups is pivotal for recommending adjuvant treatment: instillation of chemotherapy (immediate post-operative, standard schedule) or intravesical BCG (standard schedule and maintenance). Cystectomy is recommended in BCG-refractory patients. Extension evaluation of MIBC is based on pelvic-abdominal and thoracic CT-scan, MRI and FDGPET remain optional. Cystectomy associated with extensive lymph nodes resection is considered the gold standard for non metastatic MIBC. An orthotopic bladder substitution should be proposed to both male and female patients lacking any contraindications and in cases of negative frozen urethral samples, otherwise trans-ileal ureterostomy is recommended as urinary diversion. The interest of neoadjuvant chemotherapy is well known for advanced MIBC as T3-T4 and/or N1-3. As regards metastatic MIBC, first-line chemotherapy using platin is recommended (GC or MVAC), when status (PS<1) and renal function (creatinine clearance > 60 ml/min) permits (only in 50% of cases). In second line treatment, only chemotherapy using vinfluvine has been validated to date. Conclusion.-These new guidelines will hopefully contribute not only to improve patient management, but also diagnosis and treatment for NMIBC and MIBC.

11 Guideline EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. 2013

Babjuk, Marko / Burger, Maximilian / Zigeuner, Richard / Shariat, Shahrokh F / van Rhijn, Bas W G / Compérat, Eva / Sylvester, Richard J / Kaasinen, Eero / Böhle, Andreas / Palou Redorta, Joan / Rouprêt, Morgan / Anonymous2620763. ·Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic. marek.babjuk@lfmotol.cuni.cz · ·Eur Urol · Pubmed #23827737.

ABSTRACT: CONTEXT: The first European Association of Urology (EAU) guidelines on bladder cancer were published in 2002 [1]. Since then, the guidelines have been continuously updated. OBJECTIVE: To present the 2013 EAU guidelines on non-muscle-invasive bladder cancer (NMIBC). EVIDENCE ACQUISITION: Literature published between 2010 and 2012 on the diagnosis and treatment of NMIBC was systematically reviewed. Previous guidelines were updated, and the levels of evidence and grades of recommendation were assigned. EVIDENCE SYNTHESIS: Tumours staged as Ta, T1, or carcinoma in situ (CIS) are grouped as NMIBC. Diagnosis depends on cystoscopy and histologic evaluation of the tissue obtained by transurethral resection (TUR) in papillary tumours or by multiple bladder biopsies in CIS. In papillary lesions, a complete TUR is essential for the patient's prognosis. Where the initial resection is incomplete, where there is no muscle in the specimen, or where a high-grade or T1 tumour is detected, a second TUR should be performed within 2-6 wk. The risks of both recurrence and progression may be estimated for individual patients using the EORTC scoring system and risk tables. The stratification of patients into low-, intermediate-, and high-risk groups is pivotal to recommending adjuvant treatment. For patients with a low-risk tumour, one immediate instillation of chemotherapy is recommended. Patients with an intermediate-risk tumour should receive one immediate instillation of chemotherapy followed by 1 yr of full-dose bacillus Calmette-Guérin (BCG) intravesical immunotherapy or by further instillations of chemotherapy for a maximum of 1 yr. In patients with high-risk tumours, full-dose intravesical BCG for 1-3 yr is indicated. In patients at highest risk of tumour progression, immediate radical cystectomy should be considered. Cystectomy is recommended in BCG-refractory tumours. The long version of the guidelines is available from the EAU Web site: http://www.uroweb.org/guidelines/. CONCLUSIONS: These abridged EAU guidelines present updated information on the diagnosis and treatment of NMIBC for incorporation into clinical practice. PATIENT SUMMARY: The EAU Panel on Non-muscle Invasive Bladder Cancer released an updated version of their guidelines. Current clinical studies support patient selection into different risk groups; low, intermediate and high risk. These risk groups indicate the likelihood of the development of a new (recurrent) cancer after initial treatment (endoscopic resection) or progression to more aggressive (muscle-invasive) bladder cancer and are most important for the decision to provide chemo- or immunotherapy (bladder installations). Surgical removal of the bladder (radical cystectomy) should only be considered in patients who have failed chemo- or immunotherapy, or who are in the highest risk group for progression.

12 Guideline Treatment of non muscle invasive bladder tumor related to the problem of bacillus Calmette-Guerin availability. Consensus of a Spanish expert's panel. Spanish Association of Urology. 2013

Fernández-Gómez, J M / Carballido-Rodríguez, J / Cozar-Olmo, J M / Palou-Redorta, J / Solsona-Narbón, E / Unda-Urzaiz, J M / Anonymous7140761. ·Servicio de Urología, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, España. Electronic address: jmfernandezgomez23@gmail.com. · ·Actas Urol Esp · Pubmed #23773824.

ABSTRACT: CONTEXT: Since June 2012, the has been a worldwide lack of available of the Connaught strain. In December 2012, a group of experts met in the Spanish Association of Urology to analyze this situation and propose alternatives. OBJECTIVE: To present the work performed by said committee and the resulting recommendations. ACQUISITION OF EVIDENCE: An update has been made of the principal existing evidence in the treatment of middle and high risk tumors. Special mention has been made regarding the those related with the use of BCG and their possible alternative due to the different availability of BCG. EVIDENCE SYNTHESIS: In tumors with high risk of progression, immediate cystectomy should be considered when BCG is not available, with dose reduction or alternating with chemotherapy as methods to economize on the use of BCG when availability is reduced. In tumors having middle risk of progression, chemotherapy can be used, although when it is associated to a high risk of relapse, BCG would be indicated if available with the mentioned savings guidelines. BCG requires maintenance to maintain its effectiveness, it being necessary to optimize the application of endovesical chemotherapy and to use systems that increase its penetration into the bladder wall (EMDA) if they are available. CONCLUSIONS: Due to the scarcity of BCG, it has been necessary to agree on a series of recommendations that have been published on the web page of the Spanish Association of Urology.

13 Guideline Bladder cancer. 2013

Clark, Peter E / Agarwal, Neeraj / Biagioli, Matthew C / Eisenberger, Mario A / Greenberg, Richard E / Herr, Harry W / Inman, Brant A / Kuban, Deborah A / Kuzel, Timothy M / Lele, Subodh M / Michalski, Jeff / Pagliaro, Lance C / Pal, Sumanta K / Patterson, Anthony / Plimack, Elizabeth R / Pohar, Kamal S / Porter, Michael P / Richie, Jerome P / Sexton, Wade J / Shipley, William U / Small, Eric J / Spiess, Philippe E / Trump, Donald L / Wile, Geoffrey / Wilson, Timothy G / Dwyer, Mary / Ho, Maria / Anonymous5370755. ·Vanderbilt-Ingram Cancer Center. · ·J Natl Compr Canc Netw · Pubmed #23584347.

ABSTRACT: Bladder cancer is the fourth most common cancer in the United States. Urothelial carcinoma that originates from the urinary bladder is the most common subtype. These NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) provide recommendations on the diagnosis and management of non-muscle-invasive and muscle-invasive urothelial carcinoma of the bladder. This version of the guidelines provides extensive reorganization and updates on the principles of chemotherapy management.

14 Guideline ICUD-EAU International Consultation on Bladder Cancer 2012: Screening, diagnosis, and molecular markers. 2013

Kamat, Ashish M / Hegarty, Paul K / Gee, Jason R / Clark, Peter E / Svatek, Robert S / Hegarty, Nicholas / Shariat, Shahrokh F / Xylinas, Evanguelos / Schmitz-Dräger, Bernd J / Lotan, Yair / Jenkins, Lawrence C / Droller, Michael / van Rhijn, Bas W / Karakiewicz, Pierre I / Anonymous2410740. ·Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA. akamat@mdanderson.org · ·Eur Urol · Pubmed #23083902.

ABSTRACT: CONTEXT AND OBJECTIVE: To present a summary of the 2nd International Consultation on Bladder Cancer recommendations on the screening, diagnosis, and markers of bladder cancer using an evidence-based strategy. EVIDENCE ACQUISITION: A detailed Medline analysis was performed for original articles addressing bladder cancer with regard to screening, diagnosis, markers, and pathology. Proceedings from the last 5 yr of major conferences were also searched. EVIDENCE SYNTHESIS: The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analyzed. CONCLUSIONS: Cystoscopy alone is the most cost-effective method to detect recurrence of bladder cancer. White-light cystoscopy is the gold standard for evaluation of the lower urinary tract; however, technology like fluorescence-aided cystoscopy and narrow-band imaging can aid in improving evaluations. Urine cytology is useful for the diagnosis of high-grade tumor recurrence. Molecular medicine holds the promise that clinical outcomes will be improved by directing therapy toward the mechanisms and targets associated with the growth of an individual patient's tumor. The challenge remains to optimize measurement of these targets, evaluate the impact of such targets for therapeutic drug development, and translate molecular markers into the improved clinical management of bladder cancer patients. Physicians and researchers eventually will have a robust set of molecular markers to guide prevention, diagnosis, and treatment decisions for bladder cancer.

15 Guideline ICUD-EAU International Consultation on Bladder Cancer 2012: Pathology. 2013

Amin, Mahul B / McKenney, Jesse K / Paner, Gladell P / Hansel, Donna E / Grignon, David J / Montironi, Rodolfo / Lin, Oscar / Jorda, Merce / Jenkins, Lawrence C / Soloway, Mark / Epstein, Jonathan I / Reuter, Victor E / Anonymous2380740. ·Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Mahul.Amin@cshs.org · ·Eur Urol · Pubmed #23083804.

ABSTRACT: CONTEXT: To present a summary of the 2nd International Consultation on Bladder Cancer recommendations on the pathology of bladder cancer using an evidence-based strategy. OBJECTIVE: To standardize descriptions of the diagnosis and reporting of urothelial carcinoma of the bladder and help optimize uniformity between individual pathology practices and institutions. EVIDENCE ACQUISITION: A detailed Medline analysis was performed for original articles addressing bladder cancer with regard to pathology. Proceedings from the last 5 yr of major conferences were also searched. EVIDENCE SYNTHESIS: The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analyzed. CONCLUSIONS: Providing the best management for patients with bladder neoplasia relies on close cooperation and teamwork among urologists, oncologists, radiologists, and pathologists.

16 Guideline ICUD-EAU International Consultation on Bladder Cancer 2012: Urinary diversion. 2013

Hautmann, Richard E / Abol-Enein, Hassan / Davidsson, Thomas / Gudjonsson, Sigurdur / Hautmann, Stefan H / Holm, Henriette V / Lee, Cheryl T / Liedberg, Frederik / Madersbacher, Stephan / Manoharan, Murugesan / Mansson, Wiking / Mills, Robert D / Penson, David F / Skinner, Eila C / Stein, Raimund / Studer, Urs E / Thueroff, Joachim W / Turner, William H / Volkmer, Bjoern G / Xu, Abai / Anonymous4610737. ·University of Ulm, Germany. richard.hautmann@uni-ulm.de · ·Eur Urol · Pubmed #22995974.

ABSTRACT: CONTEXT: A summary of the 2nd International Consultation on Bladder Cancer recommendations on the reconstructive options after radical cystectomy (RC), their outcomes, and their complications. OBJECTIVE: To review the literature regarding indications, surgical details, postoperative care, complications, functional outcomes, as well as quality-of-life measures of patients with different forms of urinary diversion (UD). EVIDENCE ACQUISITION: An English-language literature review of data published between 1970 and 2012 on patients with UD following RC for bladder cancer was undertaken. No randomized controlled studies comparing conduit diversion with neobladder or continent cutaneous diversion have been performed. Consequently, almost all studies used in this report are of level 3 evidence. Therefore, the recommendations given here are grade C only, meaning expert opinion delivered without a formal analysis. EVIDENCE SYNTHESIS: Indications and patient selection criteria have significantly changed over the past 2 decades. Renal function impairment is primarily caused by obstruction. Complications such as stone formation, urine outflow, and obstruction at any level must be recognized early and treated. In patients with orthotopic bladder substitution, daytime and nocturnal continence is achieved in 85-90% and 60-80%, respectively. Continence is inferior in elderly patients with orthotopic reconstruction. Urinary retention remains significant in female patients, ranging from 7% to 50%. CONCLUSIONS: RC and subsequent UD have been assessed as the most difficult surgical procedure in urology. Significant disparity on how the surgical complications were reported makes it impossible to compare postoperative morbidity results. Complications rates overall following RC and UD are significant, and when strict reporting criteria are incorporated, they are much higher than previously published. Fortunately, most complications are minor (Clavien grade 1 or 2). Complications can occur up to 20 yr after surgery, emphasizing the need for lifelong monitoring. Evidence suggests an association between surgical volume and outcome in RC; the challenge of optimum care for elderly patients with comorbidities is best mastered at high-volume hospitals by high-volume surgeons. Preoperative patient information, patient selection, surgical techniques, and careful postoperative follow-up are the cornerstones to achieve good long-term results.

17 Guideline ICUD-EAU International Consultation on Bladder Cancer 2012: Non-muscle-invasive urothelial carcinoma of the bladder. 2013

Burger, Maximilian / Oosterlinck, Willem / Konety, Badrinath / Chang, Sam / Gudjonsson, Sigurdur / Pruthi, Raj / Soloway, Mark / Solsona, Eduardo / Sved, Paul / Babjuk, Marko / Brausi, Maurizio A / Cheng, Christopher / Comperat, Eva / Dinney, Colin / Otto, Wolfgang / Shah, Jay / Thürof, Joachim / Witjes, J Alfred / Anonymous1690737. ·Department of Urology and Pediatric Urology, Julius-Maximilians-University Medical Center, Würzburg, Germany. · ·Eur Urol · Pubmed #22981672.

ABSTRACT: CONTEXT: Our aim was to present a summary of the Second International Consultation on Bladder Cancer recommendations on the diagnosis and treatment options for non-muscle-invasive urothelial cancer of the bladder (NMIBC) using an evidence-based approach. OBJECTIVE: To critically review the recent data on the management of NMIBC to arrive at a general consensus. EVIDENCE ACQUISITION: A detailed Medline analysis was performed for original articles addressing the treatment of NMIBC with regard to diagnosis, surgery, intravesical chemotherapy, and follow-up. Proceedings from the last 5 yr of major conferences were also searched. EVIDENCE SYNTHESIS: The major findings are presented in an evidence-based fashion. We analyzed large retrospective and prospective studies. CONCLUSIONS: Urothelial cancer of the bladder staged Ta, T1, and carcinoma in situ (CIS), also indicated as NMIBC, poses greatly varying but uniformly demanding challenges to urologic care. On the one hand, the high recurrence rate and low progression rate with Ta low-grade demand risk-adapted treatment and surveillance to provide thorough care while minimizing treatment-related burden. On the other hand, the propensity of Ta high-grade, T1, and CIS to progress demands intense care and timely consideration of radical cystectomy.

18 Guideline ICUD-EAU International Consultation on Bladder Cancer 2012: Urothelial carcinoma of the prostate. 2013

Palou, Juan / Wood, David / Bochner, Bernard H / van der Poel, Henk / Al-Ahmadie, Hikmat A / Yossepowitch, Ofer / Soloway, Mark S / Jenkins, Lawrence C / Anonymous6170735. ·Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain. jpalou@fundacio-puigvert.es · ·Eur Urol · Pubmed #22938869.

ABSTRACT: CONTEXT: The Second International Consultation on Bladder Cancer recommendations on urothelial carcinoma (UC) of the prostate were presented at the 2011 European Association of Urology Congress in Vienna, Austria, on March 18, 2011. OBJECTIVE: Our aim is to summarize the Second International Consultation on Bladder Cancer recommendations on UC of the prostate to help clinicians assess the current evidence-based management. EVIDENCE ACQUISITION: The committee performed a thorough review of new data and updated previous recommendations. Levels of evidence and grades of recommendation were assigned based on a systematic review of the literature that included a search of online databases and review articles. EVIDENCE SYNTHESIS: Once a non-muscle-invasive high-grade tumor or carcinoma in situ (CIS) of the bladder has been diagnosed, careful follow-up of the prostatic urethra is necessary. Noninvasive UC including CIS of the prostate should be treated with intravesical bacillus Calmette-Guérin (BCG) following endoscopic resection. A transurethral resection of the prostate may improve contact of BCG with the prostatic urethra, and it appears that response rates to BCG are increased (level of evidence: 3). Transurethral biopsy of the prostatic urethra is effective in identifying prostatic involvement but may not accurately reveal the extent of involvement, particularly with stromal invasion. Stromal invasion by UC of the prostate carries a poor prognosis. Radical cystoprostatectomy is the treatment of choice for locoregional control in patients with prostatic stromal invasion. CONCLUSIONS: These recommendations contain updated information on the diagnosis and treatment of UC of the prostate. However, prospective trials are needed to further elucidate the best management of these patients.

19 Guideline ICUD-EAU International Consultation on Bladder Cancer 2012: Radical cystectomy and bladder preservation for muscle-invasive urothelial carcinoma of the bladder. 2013

Gakis, Georgios / Efstathiou, Jason / Lerner, Seth P / Cookson, Michael S / Keegan, Kirk A / Guru, Khurshid A / Shipley, William U / Heidenreich, Axel / Schoenberg, Mark P / Sagaloswky, Arthur I / Soloway, Mark S / Stenzl, Arnulf / Anonymous1530735. ·Department of Urology, University Hospital Tuebingen, Germany. georgios.gakis@med.uni-tuebingen.de · ·Eur Urol · Pubmed #22917985.

ABSTRACT: CONTEXT: New guidelines of the International Consultation on Urological Diseases for the treatment of muscle-invasive bladder cancer (MIBC) have recently been published. OBJECTIVE: To provide a comprehensive overview of the current role of radical cystectomy (RC) in MIBC. EVIDENCE ACQUISITION: A detailed Medline analysis was performed for original articles addressing the role of RC with regard to indication, timing, surgical extent, perioperative morbidity, oncologic outcome, and follow-up. The analysis also included radiation-based bladder-preserving strategies. EVIDENCE SYNTHESIS: The major findings are presented in an evidence-based fashion and are based on large retrospective unicenter and multicenter series with some prospective data. CONCLUSIONS: Open RC is the standard treatment for locoregional control of MIBC. Delay of RC is associated with reduced cancer-specific survival. In males, standard RC includes the removal of the bladder, prostate, seminal vesicles, and distal ureters; in females, RC includes an anterior pelvic exenteration including the bladder, entire urethra and adjacent vagina, uterus, and distal ureters. A procedure sparing the urethra and the urethra-supplying autonomous nerves can be performed in case of a planned orthotopic neobladder. Further technical variations (ie, seminal-sparing or vaginal-sparing techniques) aimed at improving functional outcomes must be weighed against the risk of a positive margin. Laparoscopic surgery is promising, but long-term data are required prior to accepting it as an option equivalent to the open procedure. Lymphadenectomy should remove all lymphatic tissue around the common iliac, external iliac, internal iliac, and obturator region bilaterally. Complications after RC should be reported according to the modified Clavien grading system. In selected patients with MIBC, bladder-preserving therapy with cystectomy reserved for tumor recurrence represents a safe and effective alternative to immediate RC.

20 Guideline ICUD-EAU International Consultation on Bladder Cancer 2012: Chemotherapy for urothelial carcinoma-neoadjuvant and adjuvant settings. 2013

Sternberg, Cora N / Bellmunt, Joaquim / Sonpavde, Guru / Siefker-Radtke, Arlene O / Stadler, Walter M / Bajorin, Dean F / Dreicer, Robert / George, Daniel J / Milowsky, Matthew I / Theodorescu, Dan / Vaughn, David J / Galsky, Matthew D / Soloway, Mark S / Quinn, David I / Anonymous1520735. ·Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy. cstern@mclink.it · ·Eur Urol · Pubmed #22917984.

ABSTRACT: CONTEXT: We present a summary of the Second International Consultation on Bladder Cancer recommendations on chemotherapy for the treatment of bladder cancer using an evidence-based strategy. OBJECTIVE: To review the data regarding chemotherapy in patients with clinically localized and metastatic bladder cancer with a focus on its use for patients in the neoadjuvant and adjuvant settings. EVIDENCE ACQUISITION: Medline databases were searched for original articles published prior to April 1, 2012, using the following search terms: bladder cancer, urothelial cancer, metastatic, advanced, neoadjuvant, and adjuvant therapy. Proceedings of major conferences from the last 5 yr also were searched. Novel and promising drugs currently in clinical trials were included. EVIDENCE SYNTHESIS: The major findings are addressed in an evidence-based manner. Prospective trials and important cohort data were analyzed. CONCLUSIONS: Cisplatin-based combination chemotherapy for advanced and metastatic bladder cancer is an established standard, improving overall survival. In the advanced setting, cisplatin-ineligible patients may benefit from gemcitabine and carboplatin. Meta-analyses undertaken for neoadjuvant cisplatin-based combination chemotherapy show a 5% benefit in overall survival. Pathologic complete remission may be an intermediate surrogate for survival, but requires further validation. Use of neoadjuvant chemotherapy is low, and is attributable to patient and physician choice because of limited benefit, advanced age, and comorbidities including renal and/or cardiac dysfunction. Sufficient data to support adjuvant chemotherapy are lacking.

21 Guideline [Guidelines for good practice of intravesical instillations of BCG and mitomycin C from the French national cancer committee (CC-AFU) for non-muscle invasive bladder cancer]. 2012

Rouprêt, M / Neuzillet, Y / Larré, S / Pignot, G / Coloby, P / Rébillard, X / Mongiat-Artus, P / Chartier-Kastler, E / Soulié, M / Pfister, C / Anonymous6620740. ·Service d'urologie, université Paris VI, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Paris cedex, France. morgan.roupret@psl.aphp.fr · ·Prog Urol · Pubmed #23102014.

ABSTRACT: INTRODUCTION: Intravesical BCG immunotherapy and mitomycin C are considered as the standard treatment for non-muscle invasive bladder cancer. These guidelines aim to describe the optimal condition to perform intravesical instillation of BCG or mitomycin C in order to increase its oncologic efficiency and to decrease its morbidity. METHODS: Online systematic literature search was performed on PubMed(®) until April 2010. Regulation texts, published guidelines and results of recent urologists practice study were taken into consideration. Level of evidence was assigned to each recommendation. A bibliographic research in French and English using Medline(®) and Embase(®) with the keywords "BCG", "mitomycin C", "bladder", "complication", "toxicity", "adverse reaction", "prevention" and "treatment" was performed. RESULTS: Patient information must be prior to the first intravesical instillation and should be given through a medical exam by the physician performing the procedure. The check for formal contra-indication to BCG is systematically mandatory by the physician during the medical exam. Intravesical instillation must be realized in a health center where urologic endoscopic procedures are made frequently. A recent urine culture has to be checked systematically before any instillation done either by the urologist or a specialized nurse. Contingent upon a bladder catheter has been inserted in the bladder without any injury of the lower urinary tract, the instillation can be done. The pharmaceutical agent needs to be kept two hours in the bladder. After instillation, the patient must be seated to void and also has to keep in mind that he needs to drink at least 2 liters of water per day for 2 days. CONCLUSION: To improve the oncologic performance and to reduce the risk of complication and adverse event, achievement of intravesical instillations of BCG and/or mitomycin C should follow a standardized procedure.

22 Guideline [Chemotherapy for bladder cancer: 2012 Update. From AUO ("Arbeitsgemeinschaft Urologische Onkologie") and IABC ("Interdisziplinäre Arbeitsgruppe BlasenCarcinom")]. 2012

Heck, M M / Gschwend, J E / Retz, M / Anonymous2710724 / Anonymous2720724. ·Klinikum rechts der Isar, Urologische Klinik und Poliklinik der Technischen Universität München, Ismaninger Straße 22, 81675 München. m.heck@lrz.tum.de · ·Urologe A · Pubmed #22526172.

ABSTRACT: This article summarizes contemporary standards in systemic therapy for urothelial carcinoma as well as updated results of peer-reviewed publications and international bladder cancer meetings in 2011. Both neoadjuvant and adjuvant trials for locally advanced carcinoma and data on systemic chemotherapy for metastatic bladder cancer are discussed.

23 Guideline [EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2011 update]. 2012

Babjuk, M / Oosterlinck, W / Sylvester, R / Kaasinen, E / Böhle, A / Palou-Redorta, J / Rouprêt, M / Anonymous190720. ·Servicio de Urología, Hospital Motol, Segunda Facultad de Medicina, Universidad Carolina, Praga, República Checa. Marek.badjuk@lfmotol.cuni.cz · ·Actas Urol Esp · Pubmed #22386115.

ABSTRACT: CONTEXT AND OBJECTIVE: To present the 2011 European Association of Urology (EAU) guidelines on non-muscle-invasive bladder cancer (NMIBC). EVIDENCE ACQUISITION: Literature published between 2004 and 2010 on the diagnosis and treatment of NMIBC was systematically reviewed. Previous guidelines were updated, and the level of evidence and grade of recommendation were assigned. EVIDENCE SYNTHESIS: Tumours staged as Ta, T1, or carcinoma in situ (CIS) are grouped as NMIBC. Diagnosis depends on cystoscopy and histologic evaluation of the tissue obtained by transurethral resection (TUR) in papillary tumours or by multiple bladder biopsies in CIS. In papillary lesions, a complete TUR is essential for the patient's prognosis. Where the initial resection is incomplete or where a high-grade or T1 tumour is detected, a second TUR should be performed within 2-6 wk. In papillary tumours, the risks of both recurrence and progression may be estimated for individual patients using the scoring system and risk tables. The stratification of patients into low-, intermediate-, and high-risk groups (separately for recurrence and progression) is pivotal to recommending adjuvant treatment. For patients with a low risk of tumour recurrence and progression, one immediate instillation of chemotherapy is recommended. Patients with an intermediate or high risk of recurrence and an intermediate risk of progression should receive one immediate instillation of chemotherapy followed by a minimum of 1 yr of bacillus Calmette-Guérin (BCG) intravesical immunotherapy or further instillations of chemotherapy. Papillary tumours with a high risk of progression and CIS should receive intravesical BCG for 1 yr. Cystectomy may be offered to the highest risk patients, and it is at least recommended in BCG failure patients. CONCLUSIONS: These abridged EAU guidelines present updated information on the diagnosis and treatment of NMIBC for incorporation into clinical practice.

24 Guideline [Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU guidelines]. 2012

Stenzl, A / Cowan, N C / De Santis, M / Kuczyk, M A / Merseburger, A S / Ribal, M J / Sherif, A / Witjes, J A / Anonymous180720. ·Servicio de Urología, Universidad Eberhard-KarlsTuebingen, Alemania. Urologie@med.uni-tuebingen.de · ·Actas Urol Esp · Pubmed #22386114.

ABSTRACT: CONTEXT: New data regarding treatment of muscle-invasive and metastatic bladder cancer (MiM-BC) has emerged and led to an update of the European Association of Urology (EAU) guidelines for MiM-BC. OBJECTIVE: To review the new EAU guidelines for MiM-BC with a specific focus on treatment. EVIDENCE ACQUISITION: New literature published since the last update of the EAU guidelines in 2008 was obtained from Medline, the Cochrane Database of Systematic Reviews, and reference lists in publications and review articles and comprehensively screened by a group of urologists, oncologists, and a radiologist appointed by the EAU Guidelines Office. Previous recommendations based on the older literature on this subject were also taken into account. Levels of evidence (LEs) and grades of recommendations (GRs) were added based on a system modified from the Oxford Centre for Evidence-based Medicine Levels of Evidence. EVIDENCE SYNTHESIS: Current data demonstrate that neoadjuvant chemotherapy in conjunction with radical cystectomy (RC) is recommended in certain constellations of MiM-BC. RC remains the basic treatment of choice in localised invasive disease for both sexes. An attempt has been made to define the extent of surgery under standard conditions in both sexes. An orthotopic bladder substitute should be offered to both male and female patients lacking any contraindications, such as no tumour at the level of urethral dissection. In contrast to neoadjuvant chemotherapy, current advice recommends the use of adjuvant chemotherapy only within clinical trials. Multimodality bladder-preserving treatment in localised disease is currently regarded only as an alternative in selected, well-informed, and compliant patients for whom cystectomy is not considered for medical or personal reasons. In metastatic disease, the first-line treatment for patients fit enough to sustain cisplatin remains cisplatin-containing combination chemotherapy. With the advent of vinflunine, second-line chemotherapy has become available. CONCLUSIONS: In the treatment of localised invasive bladder cancer (BCa), the standard treatment remains radical surgical removal of the bladder within standard limits, including as-yet-unspecified regional lymph nodes. However, the addition of neoadjuvant chemotherapy must be considered for certain specific patient groups. A new drug for second-line chemotherapy (vinflunine) in metastatic disease has been approved and is recommended.

25 Guideline Australian & New Zealand Faculty of Radiation Oncology Genito-Urinary Group: 2011 consensus guidelines for curative radiotherapy for urothelial carcinoma of the bladder. 2012

Hindson, Benjamin R / Turner, Sandra L / Millar, Jeremy L / Foroudi, Farshad / Gogna, N Kumar / Skala, Marketa / Kneebone, Andrew / Christie, David R H / Lehman, Margot / Wiltshire, Kirsty L / Tai, Keen-Hun / Anonymous3770718. ·William Buckland Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia. ben.hindson@wbrc.org.au · ·J Med Imaging Radiat Oncol · Pubmed #22339742.

ABSTRACT: Curative radiotherapy, with or without concurrent chemotherapy, is recognized as a standard treatment option for muscle-invasive bladder cancer. It is commonly used for two distinct groups of patients: either for those medically unfit for surgery, or as part of a 'bladder preserving' management plan incorporating the possibility of salvage cystectomy. However, in both situations, the approach to radiotherapy varies widely around the world. The Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recognised a need to develop consistent, evidence-based guidelines for patient selection and radiotherapy technique in the delivery of curative radiotherapy. Following a workshop convened in May 2009, a working party collated opinions and conducted a wide literature appraisal linking each recommendation with the best available evidence. This process was subject to ongoing re-presentation to the Faculty of Radiation Oncology Genito-Urinary Group members prior to final endorsement. These Guidelines include patient selection, radiation target delineation, dose and fractionation schedules, normal tissue constraints and investigational techniques. Particular emphasis is given to the rationale for the target volumes described. These Guidelines provide a consensus-based framework for the delivery of curative radiotherapy for muscle-invasive bladder cancer. Widespread input from radiation oncologists treating bladder cancer ensures that these techniques are feasible in practice. We recommend these Guidelines be adopted widely in order to encourage a uniformly high standard of radiotherapy in this setting, and to allow for better comparison of outcomes.

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