[The therapeutic dilemma of the early invasive bladder cancer]

Transitional tumours of the bladder are classically divided in superficial (lesions of the mucosa and the submucosa) and invasive (infiltrating the detrusor) cancers. However, the recurrence and progression rate of submucosal urothelial cancers is highly variable. Therefore, management of such neoplasias is very challenging, some patients requiring a cystectomy, whereas others can be managed less invasively with endoscopic resection eventually associated with intravesical chemotherapy. We review herein the prognostic factors which help us to orientate our patients. We also emphasize the importance of the subclassification of the micro-invasive stage, and its practicability, which is reliable and simple, as opposed to the general belief.