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Bladder Cancer

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Urologic Principles and Practice

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

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Abstract

Approximately 75% of Bladder Cancer (BC) patients present with a non-muscle invasive disease (NMIBC). NMIBC represents a heterogeneous disease with different clinical outcomes. These tumors vary from low-grade to very aggressive high-grade disease showing a high risk of recurrence and progression. Thus, an early diagnosis and accurate stratification is necessary to achieve an adequate therapeutic management. TURBT is the standard procedure for the diagnosis, staging, and treatment of NMIBC. The use of an single immediate instillation of a chemotherapy agent after TURBT has some beneficial effect on BC recurrence and it should be considered in low-risk patients. Intravesical BCG immunotherapy is standard therapy for intermediate- and high-risk BC. Early radical cystectomy should be offered in a risk-adapted manner in high-grade T1 tumors with other factors of poor prognosis to improve survival and avoid the risk of overtreatment. Muscle Invasive Bladder Cancer (MIBC) represents 25% of all new diagnosed BC. MIBC is an aggressive and life-threatening disease and requires timely management in highly specialized centers. The current standard of treatment is neoadjuvant chemotherapy followed by radical cystectomy. Nevertheless, both treatments result in a high probability of complications and toxicities. Bladder preservation protocols in well-selected patients can lead to acceptable oncological outcomes with a good quality of life. The implementation of novel molecular markers for a better risk adaptation of the patients who better respond to chemotherapy, the new imaging technologies and advances in minimally invasive and robotic surgery will improve in the next future the quality of life and survival of patients with MIBC.

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Authors and Affiliations

  1. Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain

    Óscar Rodríguez Faba, José Daniel Subiela & Joan Palou

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  1. Óscar Rodríguez Faba
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  2. José Daniel Subiela
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  3. Joan Palou
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Correspondence to Joan Palou .

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  1. Sheffield Teaching Hospitals NHS Foundation, Sheffield, UK

    Christopher R. Chapple

  2. Department of Urology, University of Virginia, Charlottesville, VA, USA

    William D. Steers

  3. Department of Urologic Surgery, University of California, Davis, Sacramento, CA, USA

    Christopher P. Evans

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Faba, Ó.R., Subiela, J.D., Palou, J. (2020). Bladder Cancer. In: Chapple, C., Steers, W., Evans, C. (eds) Urologic Principles and Practice. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28599-9_34

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