PT0 after NAC: Implications for Bladder Sparing and Prognosis
Leonard G. Gomella, MD, FACS, reviews treatment options for patients with bladder cancer, including new research that could lead to bladder sparing.
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International Bladder Cancer Update 2019
Perioperative Pathways: What We Know Works
Sanjay G. Patel, MD, outlines the rationale behind implementing Enhanced Recovery After Surgery (ERAS) protocols in order to reduce stress, maintain postoperative physiology, and enhance mobilization for patients undergoing cystectomy. He then reviews the data evaluating different ERAS interventions in each perioperative period.
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Neoadjuvant/Adjuvant Chemotherapy: Are We Ready to Accept NAC as the Gold Standard?
Seth P. Lerner, MD, provides the rationale for integrating perioperative chemotherapy and radical cystectomy, describes the evidence supporting neoadjuvant chemotherapy (NAC), and reviews the limited evidence supporting adjuvant therapy for patients with bladder cancer. He then discusses the future of predictive biomarkers and precision medicine in the management of this disease.
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Bone Metastases and Mortality: Can We Be Doing More?
Leonard G. Gomella, MD, FACS, discusses the highly thrombogenic nature of bladder cancer and the burden of thromboembolic complications in patients undergoing radical cystectomy. He then reviews optimal methods and duration of prophylaxis to reduce the risk of these complications.
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Lymphadeneactomy in Invasive Bladder Cancer: Knowns and Unknowns
Seth P. Lerner, MD, describes the anatomy of and the stage specific association of lymph node metastasis, as well as evidence supporting the anatomic extent of bilateral pelvic lymphadenectomy. Additionally, he provides commentary on current Phase III clinical trials comparing extended lymph node dissection (LND) to standard LND.
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Thromboembolic Complications in Bladder Cancer
Leonard G. Gomella, MD, FACS, discusses the highly thrombogenic nature of bladder cancer and the burden of thromboembolic complications in patients undergoing radical cystectomy. He then reviews optimal methods and duration of prophylaxis to reduce the risk of these complications.
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T1 Bladder Cancer
Seth P. Lerner, MD, provides an overview of T1 bladder cancer staging and treatment, emphasizing the importance of re-TUR. He then discusses when to offer radical cystectomy or BCG, and options for patients who have failed BCG.
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Targeted Therapy for the Treatment of Advanced/Metastatic Urothelial Cancer
Daniel P. Petrylak, MD, discusses current evidence on various pathways to target when treating metastatic urothelial cancer. He reviews agents targeting the FGFR-3 and VEGF pathways, as well as two new monoclonal antibodies, enfortumab vedotin and sacituzumab govitecan.
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Urinary Markers in NMIBC: What’s New?
Sanjay G. Patel, MD, defines challenges in the detection and surveillance of bladder cancer when using FDA-approved biomarkers. He then evaluates newer DNA methylation- , DNA mutations- , and mRNA-based biomarkers and their ability to account for the limitations of traditional markers.
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Bladder Cancer and Immunotherapy
Daniel P. Petrylak, MD, reviews data regarding currently-approved immunotherapy agents for bladder cancer in first- and second-line settings. He advocates for future research regarding immunotherapy-based combinations, as well as investigating immunotherapy in earlier stages of the disease.
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Muscle Invasive Bladder Cancer: 2018 Guidelines
Michael S. Cookson, MD, MMHC, reviews highlights from the recently released American Urological Association (AUA) Guidelines for muscle invasive bladder cancer (MIBC). He focuses on initial patient evaluation, the use of neoadjuvant chemotherapy, perioperative management, patient selection for bladder preservation, and surveillance following treatment.
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Controversies in NMIBC: Guidelines and Beyond
Michael S. Cookson, MD, MMHC, reviews practice-changing recommendations from recently updated guidelines for non-muscle invasive bladder cancer (NMIBC). He specifically emphasizes the importance of variant histology and risk-stratification in treatment decision-making for NMIBC.
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