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Bladder Cancer

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An 83-year-old man was diagnosed with multiple low-grade transitional cell carcinomas over a 6-year period. A surveillance cystoscopy in year 7 showed high-grade noninvasive papillary urothelial carcinoma in the bladder trigone. A CT urogram showed a soft-tissue mass with diffuse enhancement in the lower pole of the left kidney, concerning for malignancy.

A 67-year-old man, a former smoker, presented with gross hematuria. A CT urogram showed a bladder tumor in the anterior wall and multiple enlarged retroperitoneal lymph nodes. Two vertebral metastases were seen on a bone scan. He underwent a transurethral resection of the bladder, and the pathology report revealed muscle-invasive urothelial carcinoma.

In this article, we discuss the requirements for development and validation of urine markers and the factors that hamper their clinical implementation. We also review current surveillance guidelines for NMIBC and provide an overview of approved urine markers for the detection and surveillance of NMIBC.

The combination of ramucirumab and docetaxel prolonged progression-free survival over chemotherapy alone in patients with platinum-refractory advanced urothelial carcinoma, the first time in this setting that a regimen has improved outcomes over chemotherapy.