Non-muscle invasive bladder cancer Flashcards Preview

17th European Urology Residents Education Programme > Non-muscle invasive bladder cancer > Flashcards

Flashcards in Non-muscle invasive bladder cancer Deck (23)
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1
Q

How big share of bladder cancer is non-muscle invasive?

A

~75%

2
Q

How common is recurrence of non-muscle invasive bladder cancer?

A

~70%

3
Q

What is the mortality of muscle-invasive bladder cancer?

A

50% dead in 5 years

4
Q

The layers of the bladder wall:

A

urothelium
lamina propria
muscularis propria
perivesical tissue

5
Q

What share of non-muscle invasive bladder cancer will progress?

A

~10-30%

6
Q

What share of bladder cancer is caused by occupations exposure (industrialized contries)?

A

~5-10%

7
Q

How high is the sensivity and specificity for cytology in bladder cancer?

A

Sensivity 12-48%

Specificity 87-95%

8
Q

Are there any urinary markers that you can use for screening of bladder cancer?

A

NOT YET when compared to cystoscopy

9
Q

How big share of CIS will progress to invasive bladder cancer?

A

> 30%

10
Q

What is the effect of single intravesical instillation of chemotherapy on solitary TaG1-2, <3cm no CIS?

A

Almost halves the recurrence rate

11
Q

What is the goal of TURB?

A

To perform a complete resection and make a correct diagnosis

12
Q

When is a biopsy of the prostatic urethra indicated?

A

Multifocality
CIS
Visible abnormalities in the prostate
On all re-TUR

13
Q

What are the befefits of photodynamic diagnosis in patients with non-muscle invasive bladder cancer?

A

improves the detection of CIS
lower cancer-specific motality
can help avoid perioperative single dose chemotherapy

14
Q

What is the challenge with identifying variant histology of urothelial carcinoma?

A

It can be mistaken for reactive processes or benign tumours

15
Q

Give four examples of variant histology of urothelial carcinoma:

A

Micropapillary variant
Sarcomatoid carcinoma
Plasmacytoid variant
Small cell carcinoma

16
Q

What characterizes Micropapillary variant of urothelial carcinoma?

A

Aggressive behaviour with high metastatic rate

95% are muscle-invasive at time of presentation

17
Q

What characterizes Sarcomatoid carcinoma of urothelial carcinoma?

A

No difference in survival when compared stage-for-stage with UrCa
BUT
70% of patients die within 2 years because of high stage

18
Q

What characterizes Plasmocytoid variant of urothelial carcinoma?

A

Locally infiltative & highly aggressive
Unique pattern of spread along the ureter
Chemo-sensitive but very poor prognosis

19
Q

What characterizes Small cell carcinoma of urothelial carcinoma?

A

Identical to undiffirentiated small-cell cancer of the lung
Associated with paraneoplatsic syndromes
High stage at presentation
50% disseminated disease with metastases to the brain and bone
5-year survival 16-29% (?) very poor prognosis

20
Q

How to accomplish smoking cessation?

A

A 2-3 min consultation on smoking increases the probability of smoking cessation by 60% (from 3-5%)
Nicotine substitutes
Motivational interviewing

Medicins: Bupropion and Vareniklin

21
Q

What is the effect of adjuvant intravesical chemotherapy instillations for intermediate risk tumours?

A

Reduce recurrence- but NOT progression- rates

22
Q

What is the proper management of pT1 after first TurB?

A

second resection TurB

and BCG for 1-3 years

23
Q

BCG contraindications:

A

Within 2 weeks fo TURB
Visible haematuria
After traumatic catheterisation
Symptomatic urinary tract infection