Bladder cancer
INACTIVE --- BCG or early cystectomy? Challenges in high risk NMIBC

Vladimir (75 years old)

Vladimir is a 75-year-old former ballet dancer. He’s most proud of his performance as Odette in the Swan Lake.

  • Comorbidities:
    • Arterial hypertension
    • Peripheral artery disease (PAD)
    • Former smoker (40 pack years)

Workup of painless haematuria showed a tumour on the right bladder wall.
He underwent TURBT: pT1 high grade, muscle in specimen.
After second resection, there was no evidence of disease. BCG was given for 1 year.
15 months after completion of BCG, he has recurrent disease. TURBT shows again pT1 high grade; second resection again shows no evidence of disease.

Which treatment option would you choose?