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Management of High-grade T1 Urothelial Carcinoma

  • Urothelial Cancer (S Daneshmand, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The optimal management of high-grade T1 (HGT1) urothelial carcinoma (UC) is complex given its high rate of recurrence, progression, and cancer-specific mortality as well as its clinical variability. Our current treatment paradigm has been supplemented by recent data describing the expanding options for salvage intravesical therapy, bladder preservation, and the promising role of molecular epidemiology. In the current review, we attempt to summarize and critically analyze these studies.

Recent Findings

Evidence describing new intravesical therapies has demonstrated an adequate safety profile and some efficacy in BCG-unresponsive patients who desire bladder preservation. However, response rates are still poor in this high-risk patient population, and it is important to keep these data in perspective when counseling patients. Concomitantly, the continued molecular characterization of non-muscle-invasive bladder cancer may suggest potential therapeutic targets as well as predictors of treatment response in the future.

Summary

The integration of new intravesical therapies and molecular data into the current treatment paradigm for HGT1 urothelial carcinoma will be critical to improving oncologic outcomes in this particularly high-risk population.

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  1. Department of Urology, Vanderbilt University Medical Center, A-1302 Medical Center North, Nashville, TN, 37232, USA

    Peter A. Reisz, Aaron A. Laviana & Sam S. Chang

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  1. Peter A. Reisz
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Peter A. Reisz, Aaron A. Laviana, and Sam S. Chang each declare no potential conflicts of interest.

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Reisz, P.A., Laviana, A.A. & Chang, S.S. Management of High-grade T1 Urothelial Carcinoma. Curr Urol Rep 19, 103 (2018). https://doi.org/10.1007/s11934-018-0850-8

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  • DOI: https://doi.org/10.1007/s11934-018-0850-8

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