Reply from Authors re: Marko Babjuk. New Insights in Intravesical Treatment for Intermediate- and High-Risk Non-Muscle-Invasive Urothelial Bladder Carcinoma. Eur Urol 2010;57:774-6

摘要

A complete transurethral resection (TUR) remains the cornerstone as the initial step in the diagnosis and treatment of patients with non-muscle-invasive bladder cancer (NMIBC) [1]. As there have been no recent breakthroughs in the intravesical treatment given after TUR to prevent recurrence, it is important that the currently existing treatments are used in an optimal fashion. Although intravesical chemotherapy and immunotherapy have both been used for >30 yr, important questions still remain concerning their use: What is the value of an immediate postoperative instillation of chemotherapy in intermediate- and high-risk patients? What is the optimal schedule for and duration of intravesical chemotherapy? What is the role of device-assisted chemotherapy, such as hyperthermia and electromotive drug administration? What is the optimal scheme, dose, and duration of intravesical bacillus Calmette-Guerin (BCG) treatment? In newly diagnosed high-grade Tl patients and in high-risk patients who fail BCG, what conservative treatment options, if any, should be considered prior to abandoning conservative treatment and proceeding to cystectomy? What is the role of combination and multimodality therapy? Should intravesical chemotherapy or intravesical BCG be given in intermediate-risk patients?