Extra case 5: Carlos (75 years old)

Carlos, 75 years old, is a retired engineer who enjoys building model airplanes and sharing stories with his grandchildren.

He was initially diagnosed with intermediate-risk NMIBC. He received BCG for 1 year. Follow-up cystoscopy 3 months after completion of BCG shows a 1.5 cm papillary tumour at the anterior bladder wall.

Assessment summary:

• Medical history:
  • Former smoker (40 pack years)
  • Hypertension, peripheral artery disease (PAD)
• ECOG PS: 1
• Urine cytology: suspicious for HG UCa (according to the Paris system)
• Conventional TURBT: resection visually complete, pathological review:
  • pT1 HG
  • Pure UCa
  • No LVI
  • Muscularis propria in specimen, uninvolved
• Second TURBT: no residual disease
• CT urography: cN0, no concomitant upper tract tumour