Carcinoma in situ of the urinary bladder

Urinary bladder cancer ranks 4th among cancers in men and 8th in women. Superficial bladder cancer (stages Tis, Ta and T1) accounts for 75% of bladder cancer cases, whereas carcinoma in situ (CIS) may appear as an entity of its own, or coexist with another tumor. The diagnosis of CIS is based on urine cytology, cystoscopy and biopsy. Long term follow-up is mandatory due to its high recurrence rate and its invasive potential. Because of this, radical cystectomy has been the gold standard treatment till the mid 1980's. The emergence of intravesical infusion of drugs, especially of BCG, changed the management of CIS altogether. Today, BCG infusion after the initial transurethral resection (TUR) is considered the best treatment, although a consensus regarding the ideal dosing scheme or the maintenance scheduling, has not yet been reached. This, as well as newly developedtherapeutic means, underscore the need for further study on the ideal treatment of CIS of the urinary bladder.