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Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?

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Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity? / von Deimling, Markus; Pallauf, Maximilian; Bianchi, Alberto; Laukhtina, Ekaterina; Karakiewicz, Pierre I; Rink, Michael; Shariat, Shahrokh F; Pradere, Benjamin.

In: CURR OPIN UROL, Vol. 32, No. 5, 01.09.2022, p. 567-574.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

von Deimling, M, Pallauf, M, Bianchi, A, Laukhtina, E, Karakiewicz, PI, Rink, M, Shariat, SF & Pradere, B 2022, 'Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?', CURR OPIN UROL, vol. 32, no. 5, pp. 567-574. https://doi.org/10.1097/MOU.0000000000001028

APA

von Deimling, M., Pallauf, M., Bianchi, A., Laukhtina, E., Karakiewicz, P. I., Rink, M., Shariat, S. F., & Pradere, B. (2022). Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity? CURR OPIN UROL, 32(5), 567-574. https://doi.org/10.1097/MOU.0000000000001028

Vancouver

von Deimling M, Pallauf M, Bianchi A, Laukhtina E, Karakiewicz PI, Rink M et al. Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity? CURR OPIN UROL. 2022 Sep 1;32(5):567-574. https://doi.org/10.1097/MOU.0000000000001028

Bibtex

@article{ac616a6c9b0d4acbb209d46065de3369,
title = "Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?",
abstract = "PURPOSE OF REVIEW: This review aims to analyze the current place of active surveillance (AS) in non-muscle-invasive bladder cancer (NMIBC).RECENT FINDINGS: A growing body of evidence suggests that AS protocols for pTa low-grade (TaLG) NMIBC are safe and feasible. However, current guidelines have not implemented AS due to a lack of high-quality data. Available studies included pTa tumors, with only one study excluding pT1-NMIBC. Inclusion/exclusion criteria were heterogeneously defined based on tumor volume, number of tumors, carcinoma in situ (CIS), or high-grade (HG) NMIBC. Tumor volume <10 mm and <5 lesions were used as cut-offs. Positive urinary cytology (UC) or cancer-related symptoms precluded inclusion. Surveillance within the first year consisted of quarterly cystoscopy. AS stopped upon the presence of cancer-related symptoms, change in tumor morphology, positive UC, or patient's request. With a median time on AS of 16 months, two-thirds of the patients failed AS. Progression to muscle-invasive bladder cancer (MIBC) was rare and occurred only in patients with pT1-NIMBC at inclusion.SUMMARY: AS in NMIBC is an attractive concept in the era of personalized medicine, but strong evidence is still awaited. A more precise definition of patient inclusion, follow-up, and failure criteria is required to improve its implementation in daily clinical practice.",
keywords = "Carcinoma in Situ/epidemiology, Cystoscopy, Humans, Neoplasm Invasiveness, Urinary Bladder Neoplasms/diagnosis, Watchful Waiting",
author = "{von Deimling}, Markus and Maximilian Pallauf and Alberto Bianchi and Ekaterina Laukhtina and Karakiewicz, {Pierre I} and Michael Rink and Shariat, {Shahrokh F} and Benjamin Pradere",
note = "Copyright {\textcopyright} 2022 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2022",
month = sep,
day = "1",
doi = "10.1097/MOU.0000000000001028",
language = "English",
volume = "32",
pages = "567--574",
journal = "CURR OPIN UROL",
issn = "0963-0643",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

RIS

TY - JOUR

T1 - Active surveillance for non-muscle-invasive bladder cancer: fallacy or opportunity?

AU - von Deimling, Markus

AU - Pallauf, Maximilian

AU - Bianchi, Alberto

AU - Laukhtina, Ekaterina

AU - Karakiewicz, Pierre I

AU - Rink, Michael

AU - Shariat, Shahrokh F

AU - Pradere, Benjamin

N1 - Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2022/9/1

Y1 - 2022/9/1

N2 - PURPOSE OF REVIEW: This review aims to analyze the current place of active surveillance (AS) in non-muscle-invasive bladder cancer (NMIBC).RECENT FINDINGS: A growing body of evidence suggests that AS protocols for pTa low-grade (TaLG) NMIBC are safe and feasible. However, current guidelines have not implemented AS due to a lack of high-quality data. Available studies included pTa tumors, with only one study excluding pT1-NMIBC. Inclusion/exclusion criteria were heterogeneously defined based on tumor volume, number of tumors, carcinoma in situ (CIS), or high-grade (HG) NMIBC. Tumor volume <10 mm and <5 lesions were used as cut-offs. Positive urinary cytology (UC) or cancer-related symptoms precluded inclusion. Surveillance within the first year consisted of quarterly cystoscopy. AS stopped upon the presence of cancer-related symptoms, change in tumor morphology, positive UC, or patient's request. With a median time on AS of 16 months, two-thirds of the patients failed AS. Progression to muscle-invasive bladder cancer (MIBC) was rare and occurred only in patients with pT1-NIMBC at inclusion.SUMMARY: AS in NMIBC is an attractive concept in the era of personalized medicine, but strong evidence is still awaited. A more precise definition of patient inclusion, follow-up, and failure criteria is required to improve its implementation in daily clinical practice.

AB - PURPOSE OF REVIEW: This review aims to analyze the current place of active surveillance (AS) in non-muscle-invasive bladder cancer (NMIBC).RECENT FINDINGS: A growing body of evidence suggests that AS protocols for pTa low-grade (TaLG) NMIBC are safe and feasible. However, current guidelines have not implemented AS due to a lack of high-quality data. Available studies included pTa tumors, with only one study excluding pT1-NMIBC. Inclusion/exclusion criteria were heterogeneously defined based on tumor volume, number of tumors, carcinoma in situ (CIS), or high-grade (HG) NMIBC. Tumor volume <10 mm and <5 lesions were used as cut-offs. Positive urinary cytology (UC) or cancer-related symptoms precluded inclusion. Surveillance within the first year consisted of quarterly cystoscopy. AS stopped upon the presence of cancer-related symptoms, change in tumor morphology, positive UC, or patient's request. With a median time on AS of 16 months, two-thirds of the patients failed AS. Progression to muscle-invasive bladder cancer (MIBC) was rare and occurred only in patients with pT1-NIMBC at inclusion.SUMMARY: AS in NMIBC is an attractive concept in the era of personalized medicine, but strong evidence is still awaited. A more precise definition of patient inclusion, follow-up, and failure criteria is required to improve its implementation in daily clinical practice.

KW - Carcinoma in Situ/epidemiology

KW - Cystoscopy

KW - Humans

KW - Neoplasm Invasiveness

KW - Urinary Bladder Neoplasms/diagnosis

KW - Watchful Waiting

U2 - 10.1097/MOU.0000000000001028

DO - 10.1097/MOU.0000000000001028

M3 - SCORING: Review article

C2 - 35869738

VL - 32

SP - 567

EP - 574

JO - CURR OPIN UROL

JF - CURR OPIN UROL

SN - 0963-0643

IS - 5

ER -