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Review Article

Current Evidence for the Treatment of Bladder Cancer

Kwang Hyun Kim, Young Yo Park
The Ewha Medical Journal 2014;37(1):1-9. Published online: March 25, 2014

Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Young Yo Park. Department of Urology, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-5157, Fax: 82-2-2654-3682, yyopark@ewha.ac.kr
• Received: January 27, 2014   • Accepted: February 5, 2014

Copyright © 2014. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Bladder cancer is the second most common malignancy in urological field. Most new cases are diagnosed as non-muscle invasive bladder cancer (NMIBC), which includes Ta, T1 or carcinoma in situ. Initial management of NMIBC is endoscopic resection, which allows both treatment and pathological staging. Urologist should consider adjuvant intravesical chemotherapy or Bacillus Calmette-Guerin (BCG) immunotherapy, depending on the tumor grade or stage to prevent recurrence and progression. Patients with muscle invasive bladder cancer (MIBC) are best treated with radical cystectomy. However, radical cystectomy should be considered even in patients with NMIBC with high risk of progression and BCG refractory tumors. Delay of radical cystectomy in these patients might lead decreased disease specific survival. Patients treated by radical cystectomy should undergo any form of the urinary diversion. Ileal conduit is still most common method for urinary diversion. Orthotopic neobladder is generally performed by experienced hands in high volume center. Patients undergoing orthotopic neobladder should be educated and manually skillful to manipulate their diversion. Neoadjuvant cisplatin-based chemotherapy is recommended based on level 1 evidence with survival benefit. Recent updated meta-analysis also demonstrated survival benefit in patients with MIBC treated by adjuvant chemotherapy.
  • Keywords: Urinary bladder neoplasms; Cystectomy; Urinary diversion
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Fig. 1
Non muscle invasive bladder cancer. (A) Cystoscopy reveals papillary bladder tumor (BT), located lateral to the left ureteral orfice. (B) The bladder mass (arrow) is detected in computed tomography on the left posterior wall of the urinary bladder with enhancement. BT, bladder tumor.
emj-37-1-g001.jpg
Fig. 2
Orthotopic neobladder formation using Studer method. (A) Ileal neobladder is consisted of afferent tubular limb and spherical reservoir. Afferent tubular limb is used for ureteral implantation and prevents ureteral reflux using bowel peristalsis. Spherical reservoir is formed by detubularization and four-cross folding of ileal segments to maximize bladder capacity and minimize intra-luminal pressure. (B) Most caudal part of the ileal neobladder is anastomosed to urethra over the urethral catheter. L, afferent tubular limb; R, spherical reservoir; N, neobladder; U, urethra.
emj-37-1-g002.jpg

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    • Clinical Study for the One Case that Sequela of Bladder Cancer Patient Treatments by Korean Medicine
      Seong-Hee Cho, Yu-Rim Song
      The Journal of Oriental Obstetrics and Gynecology.2015; 28(2): 156.     CrossRef

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    DOI: https://doi.org/10.12771/emj.2014.37.1.1
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    Current Evidence for the Treatment of Bladder Cancer
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    DOI: https://doi.org/10.12771/emj.2014.37.1.1
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    Current Evidence for the Treatment of Bladder Cancer
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    Fig. 1 Non muscle invasive bladder cancer. (A) Cystoscopy reveals papillary bladder tumor (BT), located lateral to the left ureteral orfice. (B) The bladder mass (arrow) is detected in computed tomography on the left posterior wall of the urinary bladder with enhancement. BT, bladder tumor.
    Fig. 2 Orthotopic neobladder formation using Studer method. (A) Ileal neobladder is consisted of afferent tubular limb and spherical reservoir. Afferent tubular limb is used for ureteral implantation and prevents ureteral reflux using bowel peristalsis. Spherical reservoir is formed by detubularization and four-cross folding of ileal segments to maximize bladder capacity and minimize intra-luminal pressure. (B) Most caudal part of the ileal neobladder is anastomosed to urethra over the urethral catheter. L, afferent tubular limb; R, spherical reservoir; N, neobladder; U, urethra.

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    Current Evidence for the Treatment of Bladder Cancer
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