Bladder cancer
Follow-up surveillance regimes to consider for (very) high-risk NMIBC and MIBC

Larry (66 years old)

Larry is a 66-year-old painter of still life. During garage sales, he buys the most eccentric vases for his next paintings.

He underwent cystoscopy for painless haematuria, which revealed a 3 cm papillary tumour.

Assessment summary:

  • Medical history: stable coronary artery disease, hypertension and borderline diabetes mellitus
  • No family history
  • Complete TURBT, pathological review: minimal pT2 UCa
  • Imaging: suggestive of cT2 cN0 cM0
  • CT scan of thorax/abdomen/pelvis: no distant lesions or synchronous UTUC
  • TMT:
    • No residual tumour on second TURBT
    • Intensity modulated RT on the entire bladder (55 Gy in 20 fractions)
    • Chemotherapy with fluorouracil and mitomycin C

Re-TURBT of the resection site and random bladder biopsies did not show any residual tumour.

Surveillance with cystoscopy, cytology and CT thorax/abdomen is planned for this patient.

Which surveillance option would you choose for this patient?