What are the EAU recommendations for cystoscopic follow-up of Ta, T1 and CIS bladder cancer after TURBT?

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

The EAU guidelines recommend regular cystoscopy for follow-up of patients with Ta, T1 tumors and CIS who have undergone transurethral resection of the bladder tumor. Schedules are as follows [69] :

  • Patients with low-risk Ta tumors should undergo cystoscopy at 3 months, then (if no evidence of disease is found) 9 months later, then yearly for 5 years.

  • Patients with high-risk tumors should undergo cystoscopy and urinary cytology at 3 months, then every 3 months for 2 years, every 6 months thereafter until 5 years, then yearly.

  • Patients with intermediate-risk Ta tumors should have follow-up cystoscopy and cytology on a schedule that is in between those for low- and high-risk tumors and that is adapted according to personal and subjective factors.

  • Annual upper tract imaging (CT urography or intravenous urography) is recommended for high-risk tumors (note, however, that there are no data to support annual imaging for asymptomatic, recurrence-free patients).

  • Patients with suspicious findings on cystoscopy or positive urine cytology should undergo endoscopy under anesthesia and bladder biopsies (these patients may benefit from photodynamic detection with hexaminolevulinate blue-light cystoscopy).

  • In patients with CIS, consider random biopsies (these are rarely informative) or biopsies with photodynamic diagnosis at 3 or 6 months after intravesical treatment.

  • During follow-up in patients with positive cytology and no visible tumor in the bladder, random biopsies or biopsies with photodynamic diagnosis and investigation of extravesical locations (CT urography, prostatic urethra biopsy) are recommended.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!