Non-Muscle Invasive Bladder Cancer

NMIBC risk classification, from AUA NMIBC Guidelines

NMIBC risk of recurrence and progression, from Campbell's

EORTC risk tables, from Sylvester et al

Management of positive cytology, from Campbell's

Non-Muscle Invasive Bladder Cancer (AUA management algorithm)

Risks of Recurrence and Progression

Risk Intravesical Chemotherapy Cystoscopy + Cytology Upper Tract Surveillance Notes
Low Not recommended At 3mo, then annually for 5yrs
(no cytology)
Not required (0.6-0.9% risk) Consider in-office fulguration of sub-centimeter recurrence
Intermediate Induction therapy
Maintenance therapy x1yr if complete induction response
q3-6mo for 2yrs, then q6-12mo for 2yrs, then annually "Consider"
(< 10% UTUC rate)
High Induction therapy
Maintenance therapy x3yr if complete induction response
q3-4mo for 2yrs, then q6mo for 2yrs, then annually q1-2yrs
(10% UTUC rate)
Offer up-front cystectomy for recurrent T1, CiS, LVI, and variant histology

Persistent disease and Recurrences (intermediate/high risk)

Up-Front Cystectomy for NMIBC

Prostatic urethral cancer



Administration and success

Risks/side effects

Definition of BCG failures

Other NMIBC Therapies

Mitomycin (MMC)





Other immunotherapies