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BLADDR2019 - case 2

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Your case challenge on the role of TURBT

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You answered: C
You answered: C
A) Cystoscopy control after 3 months - B) Second TURBT - C) Start BCG instillations - D) Early cystectomy
 

What would Jacques Irani do?
 
  • Although a non-invasive papillary tumour, this tumour has an aggressive high-grade G3 feature that brings it closer to CIS or T1 tumours.
  • Apart from this poor prognostic factor, the rest of the picture is reassuring: a single primary tumour that has been visually completely resected, muscle is present in the specimen and there is no LVI.
  • But was everything done to rule out an associated CIS? Is it a standard urothelial tumour without variants? Was the tumour less than 3 cm?
  • I would go for option C: BCG instillations. This is a high-risk NMIBC although not part of the subgroup of highest risk tumours. BCG treatment for at least one year is a reasonable option especially if the reservations mentioned above were ruled out.

I’m happy to discuss this case in more detail during BLADDR on 25-26 October in Paris.
 
 


What would Jacques Irani do?
  • Although a non-invasive papillary tumour, this tumour has an aggressive high-grade G3 feature that brings it closer to CIS or T1 tumours.
  • Apart from this poor prognostic factor, the rest of the picture is reassuring: a single primary tumour that has been visually completely resected, muscle is present in the specimen and there is no LVI.
  • But was everything done to rule out an associated CIS? Is it a standard urothelial tumour without variants? Was the tumour less than 3 cm?
  • I would go for option C: BCG instillations. This is a high-risk NMIBC although not part of the subgroup of highest risk tumours. BCG treatment for at least one year is a reasonable option especially if the reservations mentioned above were ruled out.

I’m happy to discuss this case in more detail during BLADDR on 25-26 October in Paris.
 

Do you have an interesting case of your own?

Up to 3 case reports will be selected by the scientific committee for discussion in the official programme of BLADDR 2019.
 

Submit your case
 


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