[Treatment of superficial bladder tumors]

Superficial bladder cancer, T1, Ta, TIS transitional cell carcinomas of the TNM classification, represent a spectrum disease with different biological behavior. The main difficulty in the management of these tumors is to predict their potential aggressiveness based on clinicopathological parameters. Their management is based on endoscopy findings and histopathological analysis. For low risk tumors, transurethral resection and surveillance allow an adequate tumor control. For high risk tumors, conservative treatment is based on a complete transurethral resection and prophylactic endovesical instillations of bacillus Calmette-Guérin. For intermediate risk lesions, the advantage of prophylactic endovesical instillations have been finally established either using BCG or chemotherapy (mitomycine C). However in this setting, various therapeutic modalities (maintenance therapy, dose, repeat cycles) are proposed and their relative efficacy remains to be established.