![]() ![]() This may show either an orderly appearance or with easily recognizable variations in architecture and cytologic features or a predominant pattern of disorder with moderate-to-marked architectural and cytologic atypia. The 2004 revision categorizes tumors into “low-grade (LG)” or “high-grade (HG)” depending on the neoplasm of the urothelium lining papillary fronds. Grade 1 (G1) applies to tumors having the least degree, grade 3 (G3) applies to tumors having the most severe degree, and grade 2 (G2) lies in between. The 1973 version comprises grade 1 to 3 and is based on the degree of cellular anaplasia compatible for the diagnosis of malignancy. Histologically, BC is generally graded using the 1973 World Health Organization (WHO) classification system or the 2004 revision. ![]() ![]() NMIBC is defined as a superficial neoplasia confined to the mucosa, (including Ta which is a noninvasive papillary carcinoma and carcinoma in situ (CIS) which is flat and non-papillary) or lamina propria (T1) based on the American Joint Committee on Cancer (AJCC) staging system, also known as the tumor node metastases (TNM) classification. Īmong the 81,190 estimated newly diagnosed BC in the US in 2018, nearly 75% were non-muscle-invasive bladder cancer (NMIBC). As the 9th most commonly diagnosed cancer and the 13th most common cause of death worldwide, BC caused 188,000 deaths in 2015 worldwide. Registrationīladder cancer (BC) has a high morbidity in patients worldwide. Prospective randomized studies should be performed to overcome the limitations of this meta-analysis study. Quality of life should be considered equal to survival outcome hence, post-treatment follow-up needs to be performed. More specifically, late RC may be more beneficial but had a very-low-level of evidence. Conversely, RC could be a better option for younger patients. However, the superior BP modality was unclear. ConclusionsīP is a superior treatment modality compare to RC, especially for older patients and T1G3 or lower grade tumors. The mixed BP modalities were significantly better compared to RC in OS and worse in CSS, with both having a very low evidence strength. Limited data demonstrated that late RC (> 3 months) is more effective compared to early RC (< 3 months) and intravesical Bacillus Calmette–Guerin was not statistically different from that of RC. Subgroup analysis showed that BP is more appropriate for patients older than 65 and G3 tumor. ![]() As for CSS, only the 15-year OR reflected a statistical significance preferring RC. All OR of OS supported BP as a better treatment option however, all OR of PFS had no significant differences. In total, 11 cohorts with 1735 patients were selected for the meta-analysis. Subgroup analysis was performed by the original tumor state, radical cystectomy timing, bladder preservation modality, and age. Using the Review Manager 5.2 software, we used the odds ratio (OR) of specific years and HR for meta-analysis. We collected 2-year, 5-year, 10-year, and 15-year survival rate and hazard ratio (HR) for overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). Quality and publication bias were assessed using the Newcastle-Ottawa Scale and Begg’s/Egger’s test. We searched MEDLINE, The Cochrane Library, EMBASE, China National Knowledge Infrastructure, and Wanfang database through 12 April 2018. Hence, selecting the optimal treatment modality remains controversial to date. Proper management strategy selection following transurethral resection between bladder preservation (BP) and radical cystectomy (RC) could result in delayed or excessive treatment. High-grade non-muscle-invasive bladder cancer is superficial nonetheless, it is an aggressive cancer. ![]()
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