New guidelines from the American Urological Association attempt to give physicians more specific direction in the use of adjuvant therapy in patients with bladder cancer who have undergone endoscopic tumor resection.
"For patients who have not had prior intravesical therapy, adjuvant intravesical chemotherapy or immunotherapy is an option for treatment after endoscopic removal of low-grade bladder cancers," the guidelines state. "All the intravesical agents studied, when used after transurethral resection, result in lower probability of recurrence than surgery alone."
Published data show that intravesical agents used after surgery lower the likelihood of recurrence, but no evidence exists to indicate that their use affects long-term progression. "It is something that needs to be examined through further research," said Joseph A. Smith, Jr, MD, Vanderbilt University Medical Center, chair of a panel that developed the guidelines.
Chemotherapy and immunotherapy agents the panel reviewed include thiotepa, Bacille Calmette-Guérin (BCG), mitomycin C, . . . [Full Text of this Article]
