New guidance emphasizes individualized approaches to treatment
LINTHICUM, MD. The American Urological Association (AUA), together with the Society for Urologic Oncology (SUO), today released a new clinical practice guideline on non-muscle invasive bladder cancer (NMIBC). This new document outlines guidance on a variety of topics, including diagnosis and treatment, as well as a risk-stratified clinical framework for post-surgical management of this disease. The guideline will be presented at the 2016 AUA Annual Meeting in San Diego next month.
While the survival rate for the majority of patients with NMIBC (cases where the tumors are still localized to the urothelium – the innermost lining of the bladder) is favorable, certain clinical and pathological factors can impact overall prognoses and long-term outcomes. This new AUA/SUO document outlines steps that practitioners can take prior to and following surgical intervention (transurethral resection of bladder tumor, or TURBT) to better predict and manage disease progression.
Specifically, the guideline makes recommendations in the following areas:
- Diagnosis (including the role of cystoscopic examination, biopsy and cytology, upper tract imaging and visual resection)
- Risk Stratification and Pathologic Predictors (including variant histologies, cytology and urinary biomarkers)
- Surgical Intervention (including timing, techniques, goals and indications for TURBT/repeat resection, as well as the role of enhanced cystoscopy and cystectomy)
- Intravesical Therapy (Bacillus Calmette-Guerin/maintenance; combination therapies)
- BCG Relapse and Salvage Regimens
- Risk Adjusted Surveillance and Follow-Up Strategies
“We’ve come a long way in understanding bladder cancer and how to treat and manage this disease and this guideline takes our knowledge one step further by refining our approach and allowing us to provide more individualized treatment to our patients,” said Dr. Sam S. Chang, who led the panel that developed the guideline. “Determining a patient’s risk of recurrence and/or progression is an essential part of managing bladder cancer and this panel has attempted to integrate disease characteristics and treatment response.”
“We hope this proves helpful for both treating physicians and patients.”
The full guideline is available online at http://www.auanet.org/education/guidelines/non-muscle-invasive-bladder-cancer.cfm