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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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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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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