ASCO GU 2017: Barriers in Progress in Muscle-Invasive and Non-muscle Invasive Bladder Cancer - Urology Perspective - Session Highlights
Orlando, Florida USA (UroToday.com) Ashish Kamat, MD Anderson, discussed perspectives on trial design in non-muscle invasive bladder cancer. There are several myths when it comes to bladder cancer. Pathology is heterogeneous and disagreement among pathologists despite continued refinements in disease classification. An example is limited reporting of variant histology by community pathologists which carries an ominous prognosis. The American Urological Association has developed non-muscle invasive bladder cancer guidelines which has improved low, intermediate and high-risk stratification similar to the European Association of Urology guidelines. Another myth is all transurethral resection of tumors are uniform. This is not necessarily true and it is paramount to do complete resection. Use of blue light cystoscopy enhanced the detection of previously ‘invisible’ bladder tumors including carcinoma in-situ. The third myth is BCG failure is well defined. This is not necessarily true in that induction with maintenance using the SWOG regimen is the only proven regimen to decrease recurrence and progression when compared to induction alone. The 6 month assessment is imperative as 64% of patients can be salvaged with the induction and maintenance SWOG schedule if you reassess responsiveness at that initial 6 month timepoint. The final myth is the urologist follows guidelines. This does not necessarily happen as well and further efforts stressing the importance of increasing guideline adherence are needed.
Presenter: Ashish Kamat, MD Anderson
Contributed by Stephen B. Williams, MD, Assistant Professor, Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, TX and Ashish M. Kamat, MD, Professor, Department of Urology, The University of Texas MD Anderson, Houston, TX
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