According to guidelines, what is the basis for a definitive diagnosis of 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

The guidelines (AUA, EAU, ESMO, NCCN) are in agreement that the final diagnosis of bladder cancer is based on cystoscopic examination and TURBT histology. [144, 143, 69, 146, 1] The guidelines further agree that all visible lesions be resected during TURBT with bimanual examination under anesthesia (EUA) and that adequate sampling is required for proper tumor identification and staging. [144, 143, 69, 146, 1]

EUA guidelines recommend performing a second TURBT 2-6 weeks after the initial resection in any of the following situations [69] :

  • After incomplete initial TURBT
  • If there is no muscle in the specimen after initial resection, with exception of Ta low-grade tumors and, possibly, completely resected primary CIS
  • In all T1 tumors

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