Extra case 4: Fernando (71 years old)

Fernando, 71 years old, is a retired mechanic who still takes pride in maintaining his bicycle and helping neighbours with small repairs.

He was diagnosed with intermediate-risk NMIBC 4.5 years ago, which was treated with TURBT followed by intravesical chemotherapy for 1 year.

Follow-up cystoscopy 3 years after the final course of intravesical chemotherapy shows multiple reddish lesions at the anterior bladder wall.

Assessment summary:

• No relevant medical history
• ECOG PS: 0
• Urine cytology: HG UCa (according to the Paris system)

On TURBT urothelial CIS was detected. A CT urography ruled out nodal and upper tract involvement.

BCG induction was started and followed by maintenance BCG. CIS is present 3 months after the start of BCG (i.e. BCG induction completed) and persists at 6 months (i.e. first course of maintenance completed).