What are the NCCN recommendations for the treatment of low-grade Ta bladder tumors?

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

National Comprehensive Cancer Network (NCCN) recommendations for treatment of low-grade Ta tumors are as follows [1] :

  • Standard treatment for non–muscle invasive bladder cancer (NMIBC) is a complete transurethral resection of the bladder tumor (TURBT)

  • Intravesical chemotherapy is generally used as prophylactic or adjuvant therapy after complete endoscopic resection; it is rarely used as therapy to eradicate residual disease that could not be completely resected. The panel recommends a single dose of immediate intravesical chemotherapy of gemcitabine or mitomycin.
  • One postoperative intravesical dose (within 24 h, but usually immediately after resection) has been shown to reduce recurrence, but not progression, of disease for patients with low-risk NMIBC

  • Immediate intravesical chemotherapy is avoided when TURBT was extensive or perforation is suspected or the tumor appears invasive or high grade

  • Immediate intravesical chemotherapy can be followed by a 6-week induction of intravesical chemotherapy

  • Immunotherapy may be used but is not recommended


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