%0 Journal Article
%T Red patches during bladder cancer surveillance: to biopsy or not to biopsy?
%A Ditte Drejer
%A J£¿rgen Bjerggaard Jensen
%A Richard T. Bryan
%J SCIE-indexed Journal
%D 2018
%X The causes of ¡°red patches¡± (RPs) in the bladder are many and varied, ranging from minor cystoscope trauma and inflammatory lesions to carcinoma in situ (CIS). The diagnosis of the latter is crucial since CIS is a highly malignant lesion both molecularly and clinically (1), and is the single most important risk factor for progression to muscle-invasive disease in the European Organisation for Research and Treatment of Cancer (EORTC) non-muscle-invasive bladder cancer (NMIBC) risk tables (2). Thus, in the context of NMIBC, urologists face a dilemma when RPs are observed during endoscopic surveillance: to biopsy or not to biopsy. This dilemma is magnified when one considers that previous data show a pick-up rate for malignancy of only 11.9% (although CIS was diagnosed in 78.3% of these malignant biopsies) (3), and that in the presence of concomitant tumour, there is a risk of tumour cell reimplantation at the biopsy site (4), thus potentially augmenting the risk of multifocal disease. Notwithstanding, the European Association of Urology (EAU) guidelines for NMIBC recommend taking cold-cup biopsies from abnormal urothelium identified during transurethral resection of bladder tumour (TURBT) (5); the use of intravesical chemotherapy mitigates the potential risk of tumour cell reimplantation (6). However, in the flexible cystoscopy surveillance setting the dilemma remains
%U http://tau.amegroups.com/article/view/18916/19091