Witjes - Figure 6

High Risk Disease

FIG. 6:  The patients mentioned in the previous Figure are not defined as a highest-risk group by the AUA.[1]  They remain high risk, but the EAU[2] defines “very high risk” as T1G3 patients with concurrent bladder carcinoma in situ, multiple or large T1G3 and/or recurrent T1G3 tumors, T1G3 with carcinoma in situ in the prostatic urethra, and variant histology such as micropapillary cancer.  We should become familiar with these risk categories, because they are the basis for treatment recommendations in both guidelines.

References

[1]

Chang SS, Boorjian SA, Chou R, et al. Diagnosis and treatment of non-muscle invasive bladder cancer; unabridged version: American Urological Association (AUA)/Society of Urologic Oncology (SUO) guideline. Linthicum, MD: American Urological Association; 2016  https://www.auanet.org/documents/education/clinical-guidance/Non-Muscle-Invasive-Bladder-Cancer.pdf Accessed August 3, 2017.

[2]

Babjuk M, Böhle A, Burger M, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2017;71:447−61  http://dx.doi.org/10.1016/j.eururo.2016.05.041