Bladder cancer
NEW --- Treatment approaches for patients diagnosed with (very) high-risk NMIBC

Mira (69 years old)

Mira, 69 years old, spends her days meticulously crafting traditional Slavic embroidery. Unfortunately, she was diagnosed 5 years ago with low-risk NMIBC, for which she received 1 immediate intravesical instillation of chemotherapy after TURBT. Three years after the initial diagnosis, she had a low-grade papillary recurrence of 2 cm, which was treated with TURBT followed by intravesical chemotherapy for 1 year.

Follow-up cystoscopy another 2 years later shows a papillary tumour of 2.5 cm at the anterior bladder wall.

Assessment summary:

  • Medical history:
    • Former smoker (40 pack years)
    • Obesity, hypertension
  • ECOG PS: 1
  • Urine cytology: negative for HG UCa (according to the Paris system)
  • En bloc TURBT: resection visually complete, pathological review:
    • pT1 HG
    • Pure UCa
    • No LVI
    • Muscle in specimen
  • CT urography: cN0, no concomitant upper tract tumour

Which of the following options would you choose for this patient?