What are the NCCN recommendations for follow-up after segmental (partial) cystectomy or bladder preservation for bladder cancer?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

For follow-up after a segmental (partial) cystectomy or bladder preservation, the NCCN recommendations are as follows [1] :

  • Cystoscopy: Every 3 months for the first two years, every 6 months for years 3 and 4, annually for years 5 through 10. After 10 years, cystoscopy should be performed only if clinically indicated.
  • Imaging: Every 3-6 months for the first 2 years, patients with muscle-invasive bladder cancer should undergo CT or MRI urography (imaging of the upper tracts plus axial imaging of abdomen/pelvis), as well as chest x-ray or chest CT. Alternatively, FDG PET/CT (category 2B) may be performed, but only if metastatic disease is suspected. In years 3 through 5, patients should have those imaging studies annually (category 2B). After year 5, imaging is used if clinically indicated.
  • Blood tests: In the first year, patients should undergo kidney function testing and LFTs every 3-6 months, along with CBC and CMP if they received chemotherapy. Following the first year, patients should have kidney function testing and LFTs as clinically indicated.
  • Urine tests: For the first two years, patients should have urine cytology every 6-12 months. Following year 2, patients should  have urine cytology only if clinically indicated.

See Surveillance for Recurrent Bladder Cancer for more information on this topic.


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