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[Non-muscle-invasive high-grade bladder cancer]
1Klinik und Poliklinik für Urologie, Eberhard-Karls-Universität Tübingen, Tübingen, Deutschland.
Background:
Non-muscle-invasive bladder cancer with a low-grade differentiation represents a special challenge.
Method:
Although urine cytology is still the most reliable and effective urine-based marker and there are no substantial novel aspects in this field, photodynamic diagnostics have the most important value in transurethral resection of the bladder (TURB) of high-grade T1 tumors and new techniques, such as hybrid knife TURB are coming up. The histopathological assessment of T1 tumors can be supplemented by a description of the exact penetration depth, so-called substaging and the invasion pattern.
Results:
Intravesicle therapy with Bacillus Calmette-Guèrin (BCG) represents the gold standard and a pillar of bladder-preserving therapy and should be planned as maintenance therapy for at least 1 year. With the right risk constellation cystectomy is a safe and proven concept for high-grade bladder cancer, even without proof of muscle invasion.
