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🌱來自: urothelial carcinoma

Management of Nonmuscle invasive UC

Depends on T stage & grade: TURBT, followed by either observation for low risk, or intravesical therapy w/ BCG or chemo (mitomycin or gemcitabine) (Eur Urol 2021;79(4):480; J Urol 2005;174(1):86; JNCI 2001;93(8):597) Strongly consider reresection if no muscle in TURBT specimen for accurate staging The majority (50-80%) of nonmuscle invasive dz will recur if treated by TURBT alone, w/ a proportion (20-25%) progressing to more invasive dz Cystectomy considered for residual T1, high-grade or muscle-invasion at reresection BCG: Unknown exact MOA, but triggers local immune response, given weekly × 6 wks followed by maintenance for 1-3 y based on risk status for relapse. Pembrolizumab: Given IV for pts with BCG-unresponsive CIS ± papillary dz who were ineligible for or declined radical cystectomy (Lancet Onc 2021;22:919-930) Surveillance: Cystoscopy & urine cytology ∼3 mos, can be spaced if no recurrent dz

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