Non-muscle invasive bladder cancer : Current aspects of diagnostics, local therapy options and the update of the 2016 WHO classification

• Published in: Urologe. Ausgabe A Vol. 55; no. 9; pp. 1247 - 1258
• Main Authors: Karl, A, Grimm, T, Jokisch, F, Gaisa, N T, Stief, C G
• Format: Journal Article
• Language: German
• Published: Germany 01.09.2016
• Subjects: Carcinoma, Transitional Cell - diagnosis; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - therapy; Cystectomy - standards; Evidence-Based Medicine; Germany; Humans; International Classification of Diseases; Medical Oncology - standards; Muscle, Smooth - pathology; Neoplasm Invasiveness; Photochemotherapy - standards; Practice Guidelines as Topic; Treatment Outcome; Urology - standards; World Health Organization; Instillation therapy; Transurethral resection; En bloc tumor resection; Urinary bladder neoplasms; WHO classification 2016
• ISSN: 0340-2592; 1433-0563
• DOI: 10.1007/s00120-016-0192-4

Urothelial carcinoma of the bladder is known as one of most common malignant tumors in the urogenital tract. Non-muscle invasive bladder cancer (NMIBC) in particular has a high recurrence rate and results in correspondingly high costs for the public health system. To improve the recurrence rate and the prognosis of NMIBC the diagnosis, resection technique, adjuvant instillation therapy and exact histopathological classification of tumor lesions are indispensable. This article gives an overview on the current developments in this field. The current European Association of Urology (EAU) guidelines and the preliminary version of the German S3 guidelines on bladder cancer list photodynamic diagnosis (PDD) and narrow band imaging (NBI) as diagnostic procedures for tumors of the bladder. The trend for resection of bladder tumors is towards the use of en bloc resection using various techniques. Furthermore, an update of the WHO classification aims at a better identification and prognosis of the different risk groups of NMIBC. The treatment of NMIBC can only be improved by the combination of optimized diagnosis, precise tumor resection, improved adjuvant intravesical therapy and correct histopathological evaluation of tumors.