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    Bladder Ca guide provides risk-stratified framework

    Document emphasizes importance of documenting tumor size, configuration

    San Diego—A recently released guideline on diagnosis and treatment of nonmuscle-invasive bladder cancer (NMIBC) from the AUA and the Society of Urologic Oncology provides practitioners with a risk-stratified clinical framework to aid treatment decisions and surveillance strategies, said Sam S. Chang, MD, MBA.

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    Sam S. Chang, MD, MBADr. ChangDr. Chang, chair of the NMIBC guideline panel, presented highlights during a plenary session at the AUA annual meeting in San Diego.  

    “In an attempt to avoid a one-size-fits-all strategy, we wanted to take into account that the risk of recurrence and/or progression of NMIBC depends on several clinical and pathologic factors, and so we tried to personalize treatment choices and follow-up protocols,” said Dr. Chang, professor of urologic surgery and oncology, Vanderbilt University Medical Center, Nashville, TN.

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    The guideline, which includes 38 statements, was developed based on a weighted review of data. It uses a risk stratification system that builds on schemes from the European Organization for Research and Treatment of Cancer and the Spanish Urological Club for Oncological Treatment by incorporating lymphovascular invasion, prostatic urethral involvement, variant histologies, and response to bacillus Calmette–Guérin (BCG). The risk-stratified treatment recommendations are summarized in an easy-to-follow flow chart.

    Next: Evaluation and diagnosis

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