In case any abnormal-looking areas in the prostatic urethra are present at this time, these need to be biopsied as well. If biopsy is not performed during the initial procedure, it should be performed at the time of the second resection.Ģ022 recommendation: Take a prostatic urethral biopsy from the pre-collicular area (between the 5 and 7 o’clock position) using a resection loop. Revised 2023 recommendation: Take a biopsy of the prostatic urethra in cases of bladder neck tumour, if there is positive cytology or urinary molecular marker test without evidence of tumour in the bladder, or if abnormalities of the prostatic urethra are visible. If biopsy is not performed during the initial procedure, it should be completed at the time of the second resection. Section 5.1 Transurethral resection of TaT1 tumours has been revised and restructured, in particular ‘New methods of tumour visualisation’, the inclusion of Table 5.1 TURBT checklist, with changes to recommendations:Ģ022 recommendation: Take a biopsy of the prostatic urethra in cases of bladder neck tumour, if bladder carcinoma in situ is present or suspected, if there is positive cytology or urinary molecular marker test without evidence of tumour in the bladder, or if abnormalities of the prostatic urethra are visible.Revised 2023 recommendation: Use both the 19/2022 WHO classification systems, or a hybrid system. In Section 4.10 the following recommendation was revised:Ģ022 recommendation: Use both the 19/2022 WHO classification systems.Revision of Section 4.7 Subtypes of urothelial carcinoma.The inclusion of the new WHO 2022 classification resulted in new Figure 4.1 Stratification of tumours according to grade in the WHO 19/2022 classifications.Chapter 4 Pathological staging and classification systems, was significantly updated. Section 3.2 Aetiology, was restructured.Summary of changesĪdditional data has been included throughout this document text. This 2023 NMIBC Guidelines document presents a limited update of the 2022 publication. The EAU Guidelines on Bladder Cancer were first published in 2000. Publication history and summary of changes 1.4.1. All documents are accessible through the EAU website Uroweb. Several scientific publications are available, the latest publication dating to 2022, as are a number of translations of all versions of the EAU NMIBC Guidelines. This is an abridged version which may require consultation together with the full text version. Available publicationsĪ quick reference document (Pocket guidelines) is available. All experts involved in the production of this document have submitted potential conflict of interest statements which can be viewed on the EAU website Uroweb. In the course of 2021 two patient representatives have formally joined the NMIBC Panel. Members of this Panel have been selected based on their expertise and to represent the professionals treating patients suspected of suffering from bladder cancer. The EAU Guidelines Panel on NMIBC consists of an international multidisciplinary group of clinicians, including urologists, uro-oncologists, a pathologist, and a statistician. Guidelines are not mandates and do not purport to be a legal standard of care. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and references/individual circumstances of patients into account. It must be emphasised that clinical guidelines present the best evidence available to the experts, but following guideline recommendations will not necessarily result in the best outcome. Separate EAU Guidelines are available addressing upper tract urothelial carcinoma (UTUC), muscle-invasive and metastatic bladder cancer (MIBC) and primary urethral carcinoma. The aim is to provide practical recommendations on the clinical management of NMIBC with a focus on clinical presentation and recommendations. The information presented is limited to urothelial carcinoma (UC), unless specified otherwise. This overview represents the updated European Association of Urology (EAU) Guidelines for Non-muscle-invasive Bladder Cancer (NMIBC), TaT1 and carcinoma in situ (CIS).
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