On the basis of the discussion of the current state of research on relevant topics of non-muscle-invasive bladder cancer (NMIBC) among a group of experts of the Spanish Oncology Genitourinary (SOGUG) Working Group, recommendations were proposed to overcome the challenges posed by the management of NMIBC in clinical practice. A unified definition of the term 'microhematuria' and the profile of the patient at risk are needed. Establishing a 'hematuria clinic' would contribute to a centralized and more efficient evaluation of patients with this clinical sign. Second or repeated transurethral resection (re-TUR) needs to be defined, including the time window after the first procedure within which re-TUR should be performed. Complete tumor resection is mandatory when feasible, with specification of the presence or absence of muscle. Budding should be used as a classification system, and stratification of T1 tumors especially in extensive and deep tumors, is advisable. The percentage of the high-grade component should always be reported, and, in multiple tumors, grades should be reported separately. Luminal and basal subtypes can be identified because of possibly different clinical outcomes. Molecular subtypes and immunotherapy are incorporated in the management of muscle-invasive bladder cancer but data on NMIBC are still preliminary.
Cancers. 2021 Sep 23*** epublish ***
José Rubio-Briones, Ferran Algaba, Enrique Gallardo, José Antonio Marcos-Rodríguez, Miguel Ángel Climent
Urology Department, Instituto Valenciano de Oncología & Hospital VITHAS 9 de Octubre, 06009 Valencia, Spain., Pathology Section Fundació Puigvert, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain., Oncology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain., Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain., Medical Oncology Service, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain.