ABSTRACT

Non-muscle invasive bladder cancer is one of the mostly diagnosed urologic cancer, and is highly prone to new developments. These recent discoveries will,with no doubt, improve the diagnosis and predict the prognosis of urothelial cancer and response to various treatments. One of the most widely accepted improvements has been occured in the histopatological assessment of these tumors. In 1998, a new classification of non-invasive urothelial tumors was proposed by World Health Organization (WHO) and International Society of Urological Pathology (ISUP) ; and this new classification system was published by WHO in 2004. The classic way to categorize the patients with non-invasive tumors into risk categories is to use prognostic factors derived from multivariate analyses. In order to separetely predict the short and long-term risks of both recurrence and progression in individual patients, the EORTC developed scoring system and risk tables. So, keeping the probability of recurrence and progression in mind, the urologist can make a more prompt prediction for the prognosis and can decide a more appropiate adjuvant treatment for their patients. With regard to treatment options, apart from the evidence based treatment alternatives in non-invasive bladder tumors, some new developments has taken place,such as; re-TUR in selected high risk patients, single-instillation chemotherapy and new intracavitary agents in BCG refractory patients. Furthermore, new technological advances such as fluorescence cystoscopy, thermochemotherapy and electromotive drug delivery offer further hope for better outcomes even for high risk non-muscle invasive bladder tumors.