Clinical Management of Low Grade Bladder Tumors

摘要: Low-grade urothelial neoplasms have different behavior and better outcome than higher grade tumors. Noninvasive tumors are the most common bladder cancers. Seventy percent low grade. The incidence is below age of 50 but thereafter it steadily grows. World Health Organization (WHO) 2004 histological classification risk factors described. Cystoscopy method by which papillary detected. Macroscopically, low-grade lesion nicely papillary. Urinary cytology negative in majority useful at first diagnosis to predict high-grade Outpatient fulguration increasingly popular recurrent, Upper tract exploration initial performed not only for detection upper tumors, also hematuria. A complete transurethral resection (TUR) essential prognosis patient. Random biopsies inappropriate. Although TUR eradicates Ta completely they will recur very often. high variability 3-month recurrence rate indicates that incomplete or provokes recurrences. It therefore necessary consider adjuvant therapy all patients. single immediate instillation a chemotherapy agent significantly reduces advocated as standard treatment. need more instillations related prognostic factors. important multiplicity, 3 months, previous rate, size (>3 cm). Bacille Calmette-Guerin (BCG) should be used first-line treatment can second line. Evolution stage does occur less 20% patients over years. progression rare. EUA guidelines control months after advisable picks up resections next delayed 9 months. highest chance 2 years, third year, few thereafter.