Recent advances in the diagnosis and treatment of bladder cancer

Grace Cheung, Arun Sahai, Michele Billia, Prokar Dasgupta, Mohammad Shamim Khan

    Research output: Contribution to journalLiterature reviewpeer-review

    151 Citations (Scopus)

    Abstract

    Bladder cancer is the commonest malignancy of the urinary tract. In this review, we look at the latest developments in the diagnosis and management of this condition. Cystoscopy and urine cytology are the most important tools in the diagnosis and follow-up of bladder cancer. Various alternatives have been investigated, either to reduce the frequency of cystoscopy, or improve its sensitivity for detection of tumors. These include urine-based markers and point-of-care tests. Narrow-band imaging and photodynamic diagnosis/blue-light cystoscopy have shown promise in improving detection and reducing recurrence of bladder tumors, by improving the completion of bladder resection when compared with standard resection in white light. The majority of patients with a new diagnosis of bladder cancer have non-muscle-invasive bladder cancer, which requires adjuvant intravesical chemotherapy and/or immunotherapy. Recent developments in post-resection intravesical regimens are discussed. For patients with muscle-invasive bladder cancer, both laparoscopic radical cystectomy and robot-assisted radical cystectomy have been shown to reduce peri-operative morbidity, while being oncologically equivalent to open radical cystectomy in the medium term. Bladder-preserving strategies entail resection and chemoradiation, and in selected patients give equivalent results to surgery. The development, advantages, and disadvantages of these newer approaches are also discussed.

    Original languageEnglish
    Article number13
    Number of pages8
    JournalBMC Medicine
    Volume11
    DOIs
    Publication statusPublished - 17 Jan 2013

    Keywords

    • bladder cancer
    • cystoscopy
    • narrow-band imaging
    • photodynamic diagnosis
    • radical cystectomy
    • urinary markers
    • ASSISTED RADICAL CYSTECTOMY
    • RANDOMIZED CONTROLLED-TRIAL
    • TRANSITIONAL-CELL CARCINOMA
    • WHITE-LIGHT CYSTOSCOPY
    • LONG-TERM OUTCOMES
    • TRANSURETHRAL RESECTION
    • UROTHELIAL CARCINOMA
    • INITIAL-EXPERIENCE
    • CLINICAL-TRIALS
    • INTRAVESICAL CHEMOTHERAPY

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