Active surveillance for low-risk non-muscle invasive bladder cancer

Abstract

Active Surveillance (AS) is an accepted policy in several low-risk malignancies, such as prostate cancer, small renal tumours, and in clinical stage I seminomatous germ cell tumours. Regarding Bladder Cancer (BC), Non-Muscle Invasive Bladder Cancer (NMIBC) accounts for ~50% of newly diagnosed cancers; although an high percentage of local recurrence has been reported in literature, only a small number of patients will progress to Muscle Invasive Bladder Cancer (MIBC). In this context, AS might be a reasonable strategy in patients presenting with small low-grade pTa/pT1a recurrent papillary BC, with acceptable risks of stage and grade progression. Recently the mid-term results from the BIAS (BIAS: Bladder cancer Italian Active Surveillance) Project, whose primary outcome was the check of adherence to AS its self have been published.