Guideline-Driven Risk Stratification in NMIBC

The discussion opens with an overview of the evolving management of high-risk non–muscle invasive bladder cancer (NMIBC) and introduces the session’s goals of reviewing the treatment landscape, recent clinical data, and best practices for integrating new therapies. The expert faculty emphasize that accurate risk stratification is foundational to guiding treatment decisions. They review major guidelines, including those from the AUA/SUO, EAU, and NCCN, and explain how patients are categorized into low-, intermediate-, and high-risk groups based on tumor grade, size, and pathologic features. The conversation highlights key differences between these frameworks and how they influence clinical decisions in practice. The faculty note that most patients fall into the intermediate- or high-risk categories, with high-risk disease carrying the greatest threat of recurrence and progression. They also discuss the need for multidisciplinary collaboration and early risk assessment to inform appropriate, bladder-sparing therapeutic strategies in NMIBC management.