Swedish National Guidelines on Urothelial Carcinoma: 2021 update on non-muscle invasive bladder cancer and upper tract urothelial carcinoma.

To overview the updated Swedish National Guidelines on Urothelial Carcinoma 2021, with emphasis on non-muscle-invasive bladder cancer (NMIBC) and upper tract urothelial carcinoma (UTUC).

A narrative review of the updated version of the Swedish National Guidelines on Urothelial Carcinoma 2021 and highlighting new treatment recommendations, with comparison to the European Association of Urology (EAU) guidelines and current literature.

For NMIBC the new EAU 2021 risk group stratification has been introduced for non-muscle invasive bladder cancer to predict risk of progression and the web-based application has been translated to Swedish (https://nmibc.net.). For patients with non-BCG -responsive disease treatment recommendations have been pinpointed, to guide patient counselling in this clinical situation. A new recommendation in the current version of the guidelines is the introduction of four courses of adjuvant platinum-based chemotherapy to patients with advanced disease in the nephroureterectomy specimen (pT2 or higher and/or N+). Patients with papillary urothelial neoplasms with low malignant potential (PUNLMP) can be discharged from follow-up already after 3 years based on a very low subsequent risk of further recurrences.

The current version of the Swedish national guidelines introduces a new risk-stratification model and follow-up recommendation for NMIBC and adjuvant chemotherapy after radical surgery for UTUC.

Scandinavian journal of urology. 2022 Feb 28 [Epub ahead of print]

Fredrik Liedberg, Sofia Kjellström, Anna-Karin Lind, Amir Sherif, Karin Söderkvist, Karin Falkman, Helena Thulin, Firas Aljabery, Dimitrious Papantonio, Viveka Ströck, Elisabeth Öfverholm, Tomas Jerlström, Johan Sandzen, Ingrida Verbiene, Anders Ullén

Department of Urology, Skåne University Hospital, Malmö, Sweden., Department of Oncology, Skåne University Hospital, Sweden., Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden., Department of Radiation Sciences, Umeå University, Umeå, Sweden., Department of Urology, Södersjukhuset, Stockholm, Sweden., Genitourinary Oncology and Urology Unit, CLINTEC, Karolinska Institutet and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden., Division of Urology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden., Department of Oncology, Ryhov County Hospital, Jönköping, Sweden., Department of Urology, Sahlgrenska University Hospital and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden., Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden., Department of Urology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Department of Oncology, Karlstad County Hospital, Karlstad, Sweden., Department of Oncology, Uppsala Akademiska Hospital, Uppsala, Sweden., Genitourinary Oncology and Urology Unit, Department of Oncology-Pathology, Karolinska Institutet and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.