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Bladder cancer
Workup
Staging
NMIBC
INTRAVESICAL THERAPY
• BCG
• Mitomycin
• Gemcitabine
• Epirubicin
• Interferon alpha
BCG
• live attenuated form of Mycobacterium bovis;
• most commonly used agent for intravesical therapy
Surveillance & Followup
• First surveillance cystoscopy within three to four months.
• low-risk patient whose first surveillance cystoscopy is negative, a subsequent
surveillance cystoscopy 6 to 9 months later, and then annually.
• intermediate-risk patient whose first surveillance cystoscopy is negative,
subsequent cystoscopy with cytology every 3-6 months for 2 years, then 6-12
months for years 3 and 4, and then annually.
• high-risk patient whose first surveillance cystoscopy is negative, subsequent
cystoscopy with cytology every three to four months for two years, then six
months for years three and four, and then annually
• intermediate- or high-risk patient, surveillance upper tract imaging at one to two
year intervals.
BCG UNRESPONSIVE
• single intravesical 75 ml dose of nadofaragene firadenovec (3 × 1011
viral particles per ml); repeat dosing at 3, 6 and 9 months was
pursued in the absence of high-grade recurrence.
• Pembrolizumab
• Cystectomy
• EBRT
NMIBC

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Bladder cancer.pptx

  • 4.
  • 5.
  • 7. INTRAVESICAL THERAPY • BCG • Mitomycin • Gemcitabine • Epirubicin • Interferon alpha
  • 8. BCG • live attenuated form of Mycobacterium bovis; • most commonly used agent for intravesical therapy
  • 9.
  • 10.
  • 11. Surveillance & Followup • First surveillance cystoscopy within three to four months. • low-risk patient whose first surveillance cystoscopy is negative, a subsequent surveillance cystoscopy 6 to 9 months later, and then annually. • intermediate-risk patient whose first surveillance cystoscopy is negative, subsequent cystoscopy with cytology every 3-6 months for 2 years, then 6-12 months for years 3 and 4, and then annually. • high-risk patient whose first surveillance cystoscopy is negative, subsequent cystoscopy with cytology every three to four months for two years, then six months for years three and four, and then annually • intermediate- or high-risk patient, surveillance upper tract imaging at one to two year intervals.
  • 12.
  • 13. BCG UNRESPONSIVE • single intravesical 75 ml dose of nadofaragene firadenovec (3 × 1011 viral particles per ml); repeat dosing at 3, 6 and 9 months was pursued in the absence of high-grade recurrence. • Pembrolizumab • Cystectomy • EBRT
  • 14. NMIBC