From Papillary to CIS: Tailoring NMIBC Treatment

Author(s):

Mark D. Tyson, II, MD, MPH,Bogdana Schmidt, MD, MPH

Panelists discuss how specific tumor characteristics, such as papillary architecture and presence of carcinoma in situ, guide risk-adapted treatment decisions in non–muscle-invasive bladder cancer.

EP: 1.Assessing Risk in NMIBC: A Foundation for Therapy

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EP: 2.From Papillary to CIS: Tailoring NMIBC Treatment

EP: 3.Defining and Managing BCG-Unresponsive NMIBC

EP: 4.NMIBC Maintenance Therapy: Timing, Dosing, and Follow-Up

Physician Summary:

Specific tumor features—such as papillary architecture and the presence of carcinoma in situ (CIS)—play a critical role in shaping treatment decisions for NMIBC. Papillary tumors, particularly low-grade Ta lesions, often warrant a more conservative approach with surveillance and possible intravesical therapy. In contrast, CIS, due to its flat, high-grade, and aggressive nature, typically necessitates prompt and intensive treatment, often with BCG immunotherapy. Recognizing these distinctions is essential for risk-adapted management, enabling clinicians to balance efficacy with the potential risks of overtreatment or undertreatment.