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French ccAFU guidelines – Update 2018–2020: Bladder cancer

M Rouprêt1,2, Y Neuzillet1,3, G Pignot1,4

  • 1Comité de cancérologie de l’Association française d’urologie, groupe vessie, maison de l’urologie, 11, rue Viète, 75017 Paris, France

Progres En Urologie : Journal De L'Association Francaise D'Urologie Et De La Societe Francaise D'Urologie
|February 26, 2020
PubMed
Summary
This summary is machine-generated.

Updated French guidelines offer improved diagnosis and treatment strategies for non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). These evidence-based recommendations aim to enhance urological care for bladder cancer patients.

Keywords:
Urothelial carcinomaBladderCytologyBladder neoplamsCancerBCGCystectomySurvival

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Area of Science:

  • Urology
  • Oncology

Background:

  • Current French guidelines for non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) require updating.
  • Evidence-based treatment strategies are crucial for improving patient outcomes in bladder cancer management.

Observation:

  • Diagnosis of NMIBC relies on deep tumor resection, fluorescence, and second-look procedures. Risk stratification using the EORTC score guides adjuvant therapies like chemotherapy or intravesical BCG.
  • MIBC evaluation involves advanced imaging (CT, MRI). Radical cystectomy with lymph node dissection, potentially preceded by neoadjuvant chemotherapy, is standard for non-metastatic MIBC.
  • Metastatic MIBC treatment involves platinum-based chemotherapy, with immunotherapy (pembrolizumab) showing survival benefits in second-line treatment.

Findings:

  • Updated guidelines incorporate fluorescence diagnosis, risk stratification for NMIBC, and standardized treatment protocols including intravesical BCG and chemotherapy.
  • Recommendations for MIBC emphasize multimodal treatment approaches, including neoadjuvant chemotherapy and radical cystectomy with extended lymph node dissection.
  • The guidelines address surgical options, urinary diversion, and the integration of ERAS protocols for enhanced recovery after surgery.

Implications:

  • Implementation of these updated guidelines is expected to elevate the standard of urological care for both NMIBC and MIBC.
  • These guidelines provide a framework for optimizing bladder cancer diagnosis, treatment, and follow-up in France.
  • Adoption of these evidence-based recommendations can lead to improved patient outcomes and management of bladder cancer.