Comparing open-radical cystectomy and robot-assisted radical cystectomy: current status and analysis of the evidence
Purpose of review
Radical cystectomy is the definitive surgical treatment for aggressive bladder cancer. The robotic platform offers a new approach to radical cystectomy, but the benefits are unclear. This review examines the latest evidence, with a particular focus on developments in the last two years.
Recent findings
Prospective evaluations of open (ORC) and robot-assisted radical cystectomy (RARC) are emerging. The radical cystectomy in patients with bladder cancer trial reported in 2018 and demonstrated oncological noninferiority for both approaches and marginal shorter length of stays with RARC using an extracor...
Source: Current Opinion in Urology - April 1, 2020 Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
Carcinoma in situ of the bladder: why is it underdetected?
Purpose of review
The standard diagnosis of carcinoma in situ (CIS) of the bladder, based on white light cystoscopy and urine cytology, is limited because CIS can vary from normal-appearing mucosa to a lesion indistinguishable from an inflammatory process. Intravesical instillation of Bacillus Calmette–Guerin (BCG) remains first-line therapy; however, a significant proportion of cases persist or recur after BCG treatment. This review summarizes recent improvements in the detection and treatment of CIS.
Recent findings
The new optical technologies improve CIS detection, with a potential positive impact on oncological...
Source: Current Opinion in Urology - April 1, 2020 Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
Developments in the follow-up of nonmuscle invasive bladder cancer: what did we learn in the last 24 months: a critical review
Purpose of review
Patients with nonmuscle invasive bladder cancer (NMIBC) have a high risk of recurrent tumors, even in spite of contemporary guideline recommended therapy. Follow-up recommendations are also clear (cystoscopy with cytology and upper urinary tract imaging in high-risk patients), but frequency and duration of follow-up are well defined. However, recent developments in follow-up tools might be of interest for clinical practice.
Recent findings
Enhanced endoscopy improves detection and treatment of recurrences, and it can help in tailoring follow-up. However, it remains an invasive procedure. Most recentl...
Source: Current Opinion in Urology - April 1, 2020 Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
Utilization of imaging for staging in bladder cancer: is there a role for MRI or PET-computed tomography?
Purpose of review
Accurate staging of bladder cancer is essential to guide appropriate management. In this review, we discuss the principles, applications and performance of multiparametric MRI (mpMRI) and PET-computer tomography (PET-CT) for local and distant staging of bladder cancer.
Recent findings
Bladder mpMRI has a high diagnostic performance in local staging of bladder cancer, superior to other imaging modalities. It can accurately differentiate muscle invasive bladder cancer (MIBC) from non-MIBC (NMIBC), as well as ≤T2 from ≥T3 stages. mpMRI can be used to assess pelvic lymph nodes, although its sensitivi...
Source: Current Opinion in Urology - April 1, 2020 Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
Transurethral resection of bladder tumor and the need for re-transurethral resection of bladder tumor: time to change our practice?
Purpose of review
To summarize the current knowledge on the role of repeated transurethral resection of the bladder (re-TURBT) at the light of recently published trials that indicate the possibility to safely avoid it in well selected patients.
Recent findings
Recently published trials tried to predict the histology of re-TURBT with the aim of improving patients’ selection for this procedure. The en bloc resection technique seems to improve the quality of the resection, thereby diminishing and even eliminating the risk of upstaging and the residual disease rate after TURBT. Moreover, the introduction of multiparamet...
Source: Current Opinion in Urology - April 1, 2020 Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
