Active surveillance for low-risk bladder cancer

Area of Science:

• Urology
• Oncology

Background:

• Non-muscle invasive bladder cancer (NMIBC) is the most common type of bladder cancer.
• NMIBC is a diverse condition with varied prognoses and treatment strategies.
• The role of active surveillance for low-risk bladder cancer requires further investigation.

Purpose of the Study:

• To review the existing literature on the application of active surveillance for low-risk bladder cancer.
• To evaluate the efficacy and safety of active surveillance in managing this patient population.

Main Methods:

• A comprehensive literature search was conducted using PubMed.
• Keywords included: active surveillance, low risk, bladder cancer, transurethral resection of bladder tumor (TURBT), cost, and quality of life.
• Relevant studies were identified and critically reviewed.

Main Results:

• Low-risk bladder cancer (pTa, low-grade papillary tumors) has an excellent prognosis and rarely progresses.
• Bladder cancer treatment incurs high costs, partly due to high recurrence rates after TURBT.
• Recurrent low-grade tumors often necessitate multiple resections.

Conclusions:

• Selected patients with recurrent low-risk bladder cancer may be managed with office fulguration or cystoscopic surveillance.
• Active surveillance can delay or eliminate the need for TURBT, reducing surgical and anesthetic risks.
• This approach enhances quality of life without compromising oncologic outcomes.