TAILIEUCHUNG - Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and CIS)

Cells become cancer cells because of damage to DNA. DNA is in every cell and directs all its actions. In a normal cell, when DNA gets damaged the cell either repairs the damage or the cell dies. In cancer cells, the damaged DNA is not repaired, but the cell doesn’t die like it should. Instead, this cell goes on making new cells that the body does not need. These new cells will all have the same damaged DNA as the first cell does. People can inherit damaged DNA, but most DNA damage is caused by mistakes that happen while the. | Guidelines on Non-muscle-invasive Bladder Cancer TaT1 and CIS M. Babjuk W. Oosterlinck R. Sylvester E. Kaasinen A. Bohle J. Palou M. Rouprêt European Association of Urology 2012 European Association of Urology TABLE OF CONTENTS PAGE 1. BACKGROUND 4 4 4 Publication history Methodology 2. EPIDEMIOLOGY 5 3. RISK FACTORS 5 4. CLASSIFICATION 6 Tumour Node Metastasis Classification TNM 6 Histological grading of non-muscle-invasive bladder urothelial carcinomas 6 Controversial definition of non-muscle-invasive superficial tumours 8 Inter- and intra-observer variability in staging and grading 8 Specific character of carcinoma in situ CIS and its clinical classification 8 5. DIAGNOSIS 8 Symptoms 8 Physical examination 8 Imaging 8 Intravenous urography and computed tomography 8 Ultrasonography 9 Urinary cytology 9 Urinary molecular marker tests 9 Practical application of urinary cytology and markers 10 Cystoscopy 11 Transurethral resection TUR of TaT1 bladder tumours 11 Bladder and prostatic urethral biopsies 11 Photodynamic diagnosis fluorescence cystoscopy 12 Second resection 12 Pathological report 13 Recommendations for primary assessment of non-muscle-invasive bladder tumours 13 6. PREDICTING RECURRENCE AND PROGRESSION 13 TaT1 tumours 13 Carcinoma in situ 15 7. ADJUVANT TREATMENT 16 Intravesical chemotherapy 16 One immediate postoperative intravesical instillation of chemotherapy 16 Additional adjuvant intravesical chemotherapy instillations 17 Optimising intravesical chemotherapy 17 Intravesical Bacillus Calmette-Guérin BCG immunotherapy 17 Efficacy of BCG 17 Optimal BCG schedule 18 Optimal dose of BCG 18 BCG toxicity 18 Indications for BCG 18 Specific aspects of treatment of carcinoma in situ 18 Treatment strategy 18 Cohort studies 19 Prospective randomised trials 19 Treatment of .

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