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.
Source: Recent advances in the diagnosis
and treatment of bladder cancer. Cheung G, Sahai A, Billlia M, Dasgupta P, Khan
MS (shamim.khan@gstt.nhs.uk). BMC
Med. 2013 Jan 17;11(1):13.
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