Evaluation and follow-up strategies for superficial bladder cancer

Superficial bladder cancer comprises about 80% of patients presenting with bladder cancer to the practicing urologist. The risk of tumor recurrence is dependent on tumor stage, tumor grade, number of tumors (multifocality), the presence of associated carcinoma in situ, and the initial response to therapy. Clinical staging and completeness of resection of the primary tumor are essential in treatment planning, predicting the risk and site of recurrent disease, and determining follow-up strategies. The increasing frequency of extra-vesical recurrences over time requires continued observation of the upper tracts and prostatic urethra. Due to the panurothelial nature of the disease and lifelong risk of recurrence, surveillance should continue for the lifetime of the patient.