Bladder cancer

Publication date: Available online 17 August 2019Source: Surgery (Oxford)Author(s): Jameel Mushtaq, Ramesh Thurairaja, Rajesh NairAbstractUrothelial carcinoma of the bladder is the most common malignancy affecting the urinary tract. This review examines the current standards in the diagnosis and management of this disease. Cystoscopy and urine cytology remain important tools in the diagnosis and follow-up of bladder cancer. Alternatives include photodynamic diagnosis, narrow band imaging and professional image enhancement which may improve detection of tumours. En-bloc resection using either laser or electrocautery shows promise in improving the quality of transurethral resection. For patients with muscle-invasive bladder cancer, robot-assisted radical cystectomy has been shown to be oncologically equivalent to open radical cystectomy; however, cost effectiveness remains to be determined. The mainstay of bladder preservation treatment in muscle-invasive cancer is trimodal therapy utilizing transurethral resection and chemoradiotherapy with equivalent outcomes to radical cystectomy in selected patients. Management of locally advanced and metastatic disease has rapidly advanced through the use of systemic immunotherapy agents targeting the PD-L1/PD-1 axis.
Source: Surgery (Oxford) - Category: Surgery Source Type: research