What are the recommendations AUA/SUO recommendations for intravesical therapy 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

The AUA/SUO recommendations for intravesical therapy are as follows [143] :

  • For low- or intermediate-risk bladder cancer, consider a single postoperative instillation of intravesical chemotherapy (eg, mitomycin C or epirubicin) within 24 hours of TURBT.
  • After an extensive resection or if a perforation is suspected, postoperative chemotherapy should not be administered. 
  • Induction intravesical therapy should not be given to low-risk patients. 
  • Consider a 6-week course of induction intravesical chemotherapy or immunotherapy for intermediate-risk bladder cancer. 
  • In a high-risk patient with newly diagnosed CIS, high-grade T1, or high-risk Ta urothelial carcinoma, give a 6-week induction course of BCG. 
  • In an intermediate-risk patient who completely responds to an induction course of intravesical chemotherapy, maintenance therapy may be given.
  • In an intermediate-risk patient who completely responds to induction BCG, consider maintenance BCG for one year, as tolerated. 
  • In a high-risk patient who completely responds to induction BCG, continue maintenance BCG for three years, as tolerated. 

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