Evaluation and management of patients with superficial bladder cancer

The outlook for patients with bladder tumors confined to the mucosa or lamina propria has improved. The reasons are several: (1) diagnostic and therapeutic endoscopic instruments continue to improve; (2) pathologists and cytologists are providing more accurate and uniform readings of submitted material; (3) prognostic factors have been identified by cooperative groups; and (4) new effective intravesical agents have been introduced and used. I do not foresee any dramatic advances in the next few years, but I believe that the information gained over the last decade is being widely disseminated. We can hope that this will minimize diagnostic and treatment excesses for patients with little likelihood of progression, reduce the number and frequency of endoscopic resections for those with frequent recurrences, and limit the number of exenterative procedures.