Recurrence, Progression, and Follow-Up in Non-Muscle-Invasive Bladder Cancer

Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high risk of recurrence after transurethral resection of an initial tumor; the 1-yr recurrence rate is 15-61%, and the 5-yr recurrence rate is 31-78%. These figures represent the heterogeneous character of NMIBC. The treatment and follow-up (FU) strategy vary depending on initial and subsequent clinical and histopathological characteristics. Clinical prognostic factors for recurrence and progression are size, multiplicity, reaction to intravesical therapy, grade, stage, and the presence of carcinoma in situ. In addition, recurrence anywhere in the bladder at first FU cystoscopy after transurethral resection is one of the most important prognostic factors for time to progression. The major goals in treating patients with NMIBC are to prevent the high number of recurrences and to prevent muscle-invasive progression. In this review, risks of recurrence and progression are analyzed and discussed in separate sections, including clinical and pathological results, applied treatments, and diagnostics. Finally, means and recommendations for FU are discussed. (C) European Association of Urology. Published by Elsevier B.V. All rights reserved.