ESOU18: Complications of TURBT

Amsterdam, The Netherlands (UroToday.com) Transurethral resection of bladder tumor (TURBT) followed by pathologic examination of the obtained specimen, is an essential step in the treatment of non-muscle invasive bladder cancer (NMIBC). It is imperative that the resection be complete, include the muscle layer, and if needed, a second look resection should be performed.

ESOU18: Socio-economic Impact of BCG Shortage

Amsterdam, The Netherlands (UroToday.com) Bladder cancer (BC) is the ninth most common cancer in the world. The highest incidence of BC is in Northern America and Europe; and the lowest incidence is in Asia, Latin America and the Caribbean [1]. A Cochrane review assessing intravesical BCG for Ta and T1 BC found that BCG instillation after TURBT reduced disease recurrence at 12 months compared with TURBT alone. The review concluded that in people with medium- to high-risk Ta or T1 BC, intravesical BCG following TUR has a significant advantage over TUR alone in delaying tumor recurrence[2,3].

ESOU18: New Techniques for Bladder Tumor Resection - Are They Better Than Conventional TURBT?

Amsterdam, The Netherlands (UroToday.com) Transurethral resection of bladder tumor (TURBT) constitutes a crucial procedure in the diagnosis and treatment of bladder cancer (BC). A complete resection of the tumor should be achieved in all cases.  The standard utilized incision and scattering technique is against all oncological principles. It causes damage through heat, and the fragmentation of the tumour hampers histological processing. In any case, when there is incomplete resection, lack of muscle in the specimen, and in T1 tumours, a second resection is mandatory. Due to relatively high recurrence and progression rates of BC, novel imaging and tumor removal techniques are required.

ESOU18: Robotic Assisted Radical Cystectomy Does Not Always Confer the Right Urinary Diversion

Amsterdam, The Netherlands (UroToday.com)  Urinary diversion after performance of radical cystectomy (RC) can be done in several ways. Orthotopic reconstruction in the right patient, with well performed nerve-sparing surgery, and adequate follow up provides excellent clinical, oncological and functional outcomes. Nevertheless, we are witnessing a worldwide decline of usage of orthotopic reconstruction and a  growing shift to ileal conduits (IC) is seen, in high volume centers as well. 

ESOU18: The Role of Extended Lymphadenectomy for Bladder Cancer - The American Perspective

Amsterdam, The Netherlands (UroToday.com) Bilateral pelvic lymph node dissection (PLND) is an integral part of radical cystectomy (RC) for bladder cancer (BC). No consensus exists regarding the optimal extent of lymphadenectomy, the number of lymph nodes (LNs) to be retrieved, or the magnitude of the therapeutic benefit given to patients with BC. Most of the literature on the role of PLND in BC is retrospective, nonrandomized and of low quality. There is a lack of prospective randomized trials comparing limited to extended PLND in BC patients.

ESOU18: The Role of Extended Lymphadenectomy for Bladder Cancer - The European Perspective

Amsterdam, The Netherlands (UroToday.com) The standard pelvic lymph node dissection (PLND) in bladder cancer (BC) includes the external, and internal iliac and obturator nodes. It identifies over 95% of Pn1 and skip metastasis are rare. The extended PLND includes the presacral, common iliac, and distal aorta /inferior vena cava nodes. It increases node yield by 34-40%. Importantly 36-43% of Pt3, Pt4 N+ disease have node metastasis above the common iliac bifurcation. Currently there is no level 1 evidence supporting extended PLND in BC.

ESOU18: Is There a Role for Localized Treatment in Metastatic Bladder Cancer? - The Medical Oncologist Approach

Amsterdam, The Netherlands (UroToday.com) The multimodal approach should be used in treating metastatic bladder cancer (BC) patients. The therapeutic area has evolved rapidly for metastatic BC since the approval of the immune checkpoint inhibitor (ICPI) Atezolizumab (Figure 1). The current treatment algorithm for metastatic urothelial BC patients (Figure 2) involves chemotherapy at the first stage, immune checkpoint inhibitor (ICPI) and 2nd line chemotherapy. This field continues to evolve as there are currently a plethora of clinical trials for first line metastatic BC (Figure 3).
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