Urologie pro praxi 2/2022

Intravesical chemotherapy in patients with NMIBC

When treating patients with bladder cancer, it is important to classify tumours into muscle-infiltrating and non-infiltrating tumours since both the prognosis and treatment differ substantially in these two groups. Non-infiltrating bladder tumours are associated with a very heterogeneous prognosis, the estimation of which is essential for choosing the right type of adjuvant therapy. The mainstay of treatment for non-infiltrating tumours is transurethral resection, following which it is important to determine prognostic factors in order for the treatment to be successful. Evaluation of these individual factors allows the inclusion of patients in prognostic groups according to the estimated risk of progression. A different method of subsequent treatment and follow-up is recommended for each risk group. Adjuvant therapy consists in intravesical chemotherapy or immunotherapy. It must be emphasized that instillation therapy is indicated in every patient after transurethral resection, with the choice of the therapeutic agent and administration regimen being dependent on the individual prognosis. The benefit of intravesical chemotherapy has been shown in low- and medium-risk groups of patients; in high-risk patients, intravesical immunotherapy is more effective.

Keywords: bladder carcinoma, NMIBC, intravesical chemotherapy, cytostatic drugs, TUR-BT.