Bladder

Radical cystectomy is advocated for patients with high-risk non-muscle-invasive bladder cancer who develop disease recurrence following BCG therapy. A retrospective series suggests that a delay in radical cystectomy attributable to failure of salvage bladder-preserving therapies in this patient cohort is safe. However, a closer analysis of the study reveals inherent case selection that might limit such conclusions.

An effective transurethral resection of bladder tumour (TURBT) is essential to achieve safe tumour clearance and to determine the biological potential of the cancer. Attention to surgical detail within a set-up that embraces evidence-based practice, training, quality standards, prospective audit and feedback will facilitate these objectives.

Cancer sequencing studies have revealed that urothelial carcinomas harbour recurrent mutations in multiple genes that control epigenetics. A major challenge for basic and clinical researchers is to convert this genetic information into biological and pathological insights, as well as to tailor novel therapeutic modalities for individual patients with bladder cancer.