Editing Non-Muscle Invasive Bladder Cancer (section)

== Role of “timely” cystectomy ==

* Despite local therapy, many cases of high-grade NMIBC will progress to invasion and risk of cancer death
* '''The term “early” cystectomy is based on fact that they are performed before the traditional surgical indication of documented muscle invasion. A reasonable goal might be “timely” cystectomy for patients at risk.'''
** Cystectomy for CIS or persistent high-grade papillary disease after 2 courses of intravesical therapy, is the standard of care and should not be considered “early.”
* '''<span style="color:#ff0000">Indications:</span>'''
** <span style="color:#ff0000">'''See'''</span> '''[[CUA/AUA: Non-muscle Invasive Bladder Cancer (2021 CUA/2016 AUA))|2016 AUA/2021 CUA NMBIC]] <span style="color:#ff0000">Guideline Notes</span>'''
** Campbell’s:
*** High grade and invading deeply into lamina propria
*** Exhibit lymphovascular invasion
*** Associated with diffuse CIS
*** In diverticula
*** Substantially involve the distal ureters or prostatic urethra
*** Refractory to initial therapy
*** Too large or anatomically inaccessible to be removed in their entirety endoscopically
*** Patients who understand the risks and benefits of bladder preservation versus cystectomy and request definitive therapy