This protocol addresses patients with a primary low-grade or grade 1 urothelial carcinoma of the bladder at stage Ta or T1, with no concurrent carcinoma in situ (CIS). It is a first-line protocol — the tumour has not been treated before.

Clinical scenario

The qualifying patient presents with a primary (not a recurrence), single TaT1 LG/G1 bladder tumour less than 3 cm in diameter and no CIS — or a primary Ta LG/G1 tumour without CIS with at most one additional clinical risk factor. There is no muscle invasion and no concurrent carcinoma in situ.

Treatment approach — partial overview

Management begins with transurethral resection of the bladder tumour (TURBT), followed immediately by a single postoperative intravesical instillation of chemotherapy administered within 24 hours. The full protocol specifies the eligible agents, procedural requirements, and decision criteria.

Goal: no tumour recurrence on cystoscopy at 3 months

References

A primary, single, TaT1 LG/G1 tumour < 3 cm in diameter without CIS in a patient ≤ 70 years.
A primary Ta LG/G1 tumour without CIS with at most ONE of the additional clinical risk factors.
The single postoperative instillation of chemotherapy reduces the risk of recurrence and is considered sufficient treatment in these patients.
Offer one immediate instillation of intravesical chemotherapy after transurethral resection of the bladder tumour (TURBT).
The first cystoscopy after TURBT at three months is an important prognostic indicator for recurrence and progression.

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Treatment of Primary Low-Grade (Grade 1) Non-Muscle-Invasive Bladder Cancer — Stage Ta or T1, No Concurrent Carcinoma In Situ

References