Low Grade Bladder Cancer

Question 1

What are the two options for patients with LOW GRADE Ta?

Answer 1

BCG and observation

Question 2

Is intravesical therapy advised for LOW GRADE Ta?

Answer 2

Yes

Question 3

What are the drugs used for intravesical therapy in LOW GRADE Ta?

Answer 3

Gemcitabine and mitomycin

Question 4

For patients with HIGH GRADE Ta, is it necessary to do secondary surgical treatment?

Answer 4

Yes

Question 5

If yes, what are the conditions for secondary surgical treatment for HIGH GRADE Ta?

Answer 5

Repeat TURBT if incomplete resection Repeat TURBT if no muscle in specimen

Question 6

What is the procedure of choice to do in secondary surgical treatment in HIGH GRADE Ta?

Answer 6

TURBT

Question 7

What are the TWO OPTIONS for adjuvant intravesical treatment of HIGH GRADE Ta?

Answer 7

BCG and intravesical chemo with mitomycin and gemcitabine

Question 8

Which option for adjuvant intravesical treatment is preferred for HIGH GRADE Ta?

Answer 8

BCG instillation

Question 9

Is observation an option for HIGH GRADE Ta?

Answer 9

Yes

Question 10

What stage is the bladder cancer if the lamina propria is involved?

Answer 10

T1

Question 11

What are the TWO OPTIONS for secondary surgical management if the lamina propria is involved?

Answer 11

Repeat TURBT Cystectomy for high grade T1

Question 12

Is cystectomy an option for lamina propria involvement? Is there a condition?

Answer 12

Yes High grade T1

Question 13

When repeat TURBT is done for lamina propria involvement, what are the two considerations prior to doing adjuvant intravesical treatment?

Answer 13

Check if there is residual disease or no residual disease

Question 14

If there is residual disease post TURBT in cT1 patients, what are the two options available for the patient?

Answer 14

Cystectomy or BCG

Question 15

What is the preferred option residual cT1 patients?

Answer 15

BCG instillation

Question 16

Is cystectomy an option for residual cT1 patients?

Answer 16

Yes

Question 17

In residual cT1 patients, if the patient is not a cystectomy candidate, what are the available options?

Answer 17

Clinical trial or chemorad

Question 18

What are the FOUR conditions that will make you consider cystectomy in low grade bladder cancers?

Answer 18

Residual T1 High grade Muscle Invasive at re-resection Variant histology

Question 19

If no residual disease is found on repeat TURBT of patients with T1 disease, what are the 2 options for adjuvant intravesical treatment?

Answer 19

BCG and intravesical chemo with mitomycin and gemcitabine

Question 20

Which one is the preferred adjuvant intravesical treatment for cT1, post repeat TURBT, with no residual disease?

Answer 20

BCG

Question 21

Is observation an option, post repeat TURBT with no residual disease in T1 patients?

Answer 21

Yes, in hihgly selected cases

Question 22

If abovementioned question is true, give FOUR CONDITIONS to do observation.

Answer 22

Low grade small volume limited lamina propria involvement no CIS