Bladder cancer
Follow-up surveillance regimes to consider for (very) high-risk NMIBC and MIBCHenri (63 years old)
Henri is a 63-year-old consultant who enjoys glamping. The glamp sites he picks for his trips are usually located in the middle of nowhere, as he is not a people person…
He presented with macroscopic haematuria, which led to the discovery of a high-risk NMIBC. After the first cycle of 6 instillations of BCG, he relapsed.
Assessment summary:
- Former smoker (50 years)
- Medical history: gastroesophageal reflux
- Family history: sister with thyroid cancer
- Creatinine level: 91 µmol/l, eGFR: 78 ml/min
- Pathological report TURBT:
- HG papillary UCa
- Muscle in specimen, free of tumour
- pT1b without CIS
- No FGFR alteration
- CT scan of thorax/abdomen/pelvis: no distant lesions or synchronous UTUC
- Robot-assisted laparoscopic cystectomy + pelvic lymph node dissection (PLND):
- Urinary diversion by orthotopic neobladder
- Pathology report: pT0 N0 (0/37) R0
Surveillance with routine imaging with CT of the thorax and abdomen is planned for this patient. Vitamin B12 levels will be measured annually.