High-risk non-muscle invasive bladder cancer is marked by frequent disease recurrences and risk of stage progression, contributing to high surveillance, treatment-related costs, and patient anxiety.
In case of high grade non-muscle invasive bladder cancer (HG-NMIBC), intravesical BCG represents the first-line treatment; despite the "gold" standard therapy, up to 50% of patients relapse, needing radical cystectomy.
To compare the efficacy and safety of intra-arterial chemotherapy (IAC) combined with intravesical chemotherapy (IVC) against intravesical BCG immunotherapy in high-risk non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of the bladder tumor (TURBT).
Bacillus Calmette-Guerin (BCG) instillations are considered as a gold standard of therapy in high- and intermediate-risk non-muscle-invasive bladder cancer (NMIBC). Unfortunately, up to 40% of patients might experience treatment failure and even 15% of patients initially diagnosed with NMIBC will progress to muscle-invasive disease.
High-risk non-muscle-invasive bladder cancer (HR-NMIBC) represents over 30% of all incident urothelial bladder cancers (BCs); patients are at risk of progression, and 20-30% will die from BC within 5 yr.
Vesical Imaging Reporting and Data System (VI-RADS) score is adopted to provide preoperative bladder cancer (BCa) staging. Repeated transurethral resection of bladder tumor (Re-TURBT) is recommended in most of high-risk non-muscle-invasive bladder cancers (HR-NMIBCs) due to possibility of persistent/understaged disease after initial TURBT.
High-risk non-muscle invasive urinary bladder cancer (NMIBC) presents an increased risk of progression and cancer death. To reduce these risks, two different treatments are recommended - BCG or radical cystectomy (RC).
Second transurethral resection is recommended for patients diagnosed with high-risk non-muscle invasive bladder cancer; however, there have been several studies showing conflicting findings regarding the advantage of second transurethral resection.
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