Optimal management of the T1G3 bladder cancer

Murugesan Manoharan, Mark S. Soloway

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

T1G3 transitional cell carcinoma of the bladder represents a highly malignant tumor with a variable and unpredictable biologic potential. The most critical aspect of management requires a detailed discussion with the patient regarding the treatment options. Both the physician and the patient should be willing to reconsider the treatment options as the disease continues to evolve. In most cases initial management involves complete resection of the tumor, accurate staging of the disease, and intravesical immunotherapy or chemotherapy. Rigorous surveillance with long-term follow-up is crucial for managing these cases. In selected cases with adverse prognostic factors immediate cystectomy should be considered. The choice and timing of the decision to abandon bladder preservation and proceed with cystectomy should be continuously reconsidered on an individual patient basis, in concordance with the evolution of the disease (Fig. 1). The goal is to spare the bladder when possible but not at the risk of death from metastatic disease. Radical cystectomy in high-grade stage T1 transitional cell carcinoma offers excellent results in regard to the prevention of recurrence and progression and survival. Improvements in urinary diversion and nerve-sparing techniques have decreased the magnitude of social implications related to cystectomy in most patients regardless of gender. The discovery of reliable markers may contribute to better selection of patients for bladder sparing. Until then, the optimal treatment for the T1G3 tumor remains controversial.

Original languageEnglish
Pages (from-to)133-145
Number of pages13
JournalUrologic Clinics of North America
Volume32
Issue number2
DOIs
StatePublished - May 1 2005

Fingerprint

Cystectomy
Urinary Bladder Neoplasms
Urinary Bladder
Transitional Cell Carcinoma
Urinary Diversion
Neoplasm Staging
Case Management
Immunotherapy
Patient Selection
Neoplasms
Therapeutics
Physicians
Recurrence
Drug Therapy
Survival

ASJC Scopus subject areas

  • Urology

Cite this

Optimal management of the T1G3 bladder cancer. / Manoharan, Murugesan; Soloway, Mark S.

In: Urologic Clinics of North America, Vol. 32, No. 2, 01.05.2005, p. 133-145.

Research output: Contribution to journalArticle

Manoharan, Murugesan ; Soloway, Mark S. / Optimal management of the T1G3 bladder cancer. In: Urologic Clinics of North America. 2005 ; Vol. 32, No. 2. pp. 133-145.
@article{c8e0fb03f6dc46a6858626b98bdd5da4,
title = "Optimal management of the T1G3 bladder cancer",
abstract = "T1G3 transitional cell carcinoma of the bladder represents a highly malignant tumor with a variable and unpredictable biologic potential. The most critical aspect of management requires a detailed discussion with the patient regarding the treatment options. Both the physician and the patient should be willing to reconsider the treatment options as the disease continues to evolve. In most cases initial management involves complete resection of the tumor, accurate staging of the disease, and intravesical immunotherapy or chemotherapy. Rigorous surveillance with long-term follow-up is crucial for managing these cases. In selected cases with adverse prognostic factors immediate cystectomy should be considered. The choice and timing of the decision to abandon bladder preservation and proceed with cystectomy should be continuously reconsidered on an individual patient basis, in concordance with the evolution of the disease (Fig. 1). The goal is to spare the bladder when possible but not at the risk of death from metastatic disease. Radical cystectomy in high-grade stage T1 transitional cell carcinoma offers excellent results in regard to the prevention of recurrence and progression and survival. Improvements in urinary diversion and nerve-sparing techniques have decreased the magnitude of social implications related to cystectomy in most patients regardless of gender. The discovery of reliable markers may contribute to better selection of patients for bladder sparing. Until then, the optimal treatment for the T1G3 tumor remains controversial.",
author = "Murugesan Manoharan and Soloway, {Mark S.}",
year = "2005",
month = "5",
day = "1",
doi = "10.1016/j.ucl.2005.02.002",
language = "English",
volume = "32",
pages = "133--145",
journal = "Urologic Clinics of North America",
issn = "0094-0143",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - Optimal management of the T1G3 bladder cancer

AU - Manoharan, Murugesan

AU - Soloway, Mark S.

PY - 2005/5/1

Y1 - 2005/5/1

N2 - T1G3 transitional cell carcinoma of the bladder represents a highly malignant tumor with a variable and unpredictable biologic potential. The most critical aspect of management requires a detailed discussion with the patient regarding the treatment options. Both the physician and the patient should be willing to reconsider the treatment options as the disease continues to evolve. In most cases initial management involves complete resection of the tumor, accurate staging of the disease, and intravesical immunotherapy or chemotherapy. Rigorous surveillance with long-term follow-up is crucial for managing these cases. In selected cases with adverse prognostic factors immediate cystectomy should be considered. The choice and timing of the decision to abandon bladder preservation and proceed with cystectomy should be continuously reconsidered on an individual patient basis, in concordance with the evolution of the disease (Fig. 1). The goal is to spare the bladder when possible but not at the risk of death from metastatic disease. Radical cystectomy in high-grade stage T1 transitional cell carcinoma offers excellent results in regard to the prevention of recurrence and progression and survival. Improvements in urinary diversion and nerve-sparing techniques have decreased the magnitude of social implications related to cystectomy in most patients regardless of gender. The discovery of reliable markers may contribute to better selection of patients for bladder sparing. Until then, the optimal treatment for the T1G3 tumor remains controversial.

AB - T1G3 transitional cell carcinoma of the bladder represents a highly malignant tumor with a variable and unpredictable biologic potential. The most critical aspect of management requires a detailed discussion with the patient regarding the treatment options. Both the physician and the patient should be willing to reconsider the treatment options as the disease continues to evolve. In most cases initial management involves complete resection of the tumor, accurate staging of the disease, and intravesical immunotherapy or chemotherapy. Rigorous surveillance with long-term follow-up is crucial for managing these cases. In selected cases with adverse prognostic factors immediate cystectomy should be considered. The choice and timing of the decision to abandon bladder preservation and proceed with cystectomy should be continuously reconsidered on an individual patient basis, in concordance with the evolution of the disease (Fig. 1). The goal is to spare the bladder when possible but not at the risk of death from metastatic disease. Radical cystectomy in high-grade stage T1 transitional cell carcinoma offers excellent results in regard to the prevention of recurrence and progression and survival. Improvements in urinary diversion and nerve-sparing techniques have decreased the magnitude of social implications related to cystectomy in most patients regardless of gender. The discovery of reliable markers may contribute to better selection of patients for bladder sparing. Until then, the optimal treatment for the T1G3 tumor remains controversial.

UR - http://www.scopus.com/inward/record.url?scp=18144378376&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=18144378376&partnerID=8YFLogxK

U2 - 10.1016/j.ucl.2005.02.002

DO - 10.1016/j.ucl.2005.02.002

M3 - Article

VL - 32

SP - 133

EP - 145

JO - Urologic Clinics of North America

JF - Urologic Clinics of North America

SN - 0094-0143

IS - 2

ER -