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Overview of the initial approach and management of urothelial bladder cancer

Seth P Lerner, MD
Derek Raghavan, MD, PhD, FACP, FASCO
Section Editor
Jerome P Richie, MD, FACS
Deputy Editor
Michael E Ross, MD


Bladder cancer is the most common malignancy involving the urinary system. Urothelial (formerly called transitional cell) carcinoma is the predominant histologic type in the United States and Europe, where it accounts for approximately 90 percent of all bladder cancers. In other areas of the world, non-urothelial carcinomas are more frequent. Less commonly, urothelial cancers can arise in the renal pelvis, ureter, or urethra. (See "Epidemiology and risk factors of urothelial (transitional cell) carcinoma of the bladder", section on 'Epidemiology'.)

The spectrum of urothelial bladder cancer at presentation includes non-muscle-invasive, muscle-invasive, and metastatic disease. The extent of disease reflects its natural history and determines treatment and prognosis.

This topic provides an overview of the initial approach to and management of urothelial carcinoma of the bladder. More detailed discussions of these issues are found in the associated topics, as noted below.

The management of urothelial tumors arising at other sites is discussed separately, as are other types of bladder cancer:

(See "Urethral cancer".)


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Literature review current through: Feb 2017. | This topic last updated: Dec 05, 2016.
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  1. Soubra A, Hayward D, Dahm P, et al. The diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography and computed tomography in staging bladder cancer: a single-institution study and a systematic review with meta-analysis. World J Urol 2016; 34:1229.
  2. Bochner BH, Hansel DE, Efstathiou JA, et al. Urinary Bladder. In: AJCC Cancer Staging Manual, 8th, Amin MB. (Ed), Springer, New York 2017. p.757.
  3. and Genetics of Tumors of the Urinary System and Male Genital Organs. In: World Health Organization Classification of Tumors, Epstein JI, Eble JN, Sesterhenn I, Sauter G (Eds), IARC Press, Lyon, France 2004. p.93.
  4. Babjuk M, Böhle A, Burger M, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol 2017; 71:447.
  5. https://www.auanet.org/education/guidelines/bladder-cancer.cfm (Accessed on July 05, 2016).
  6. Hall MC, Chang SS, Dalbagni G, et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol 2007; 178:2314.
  7. Babjuk M, Oosterlinck W, Sylvester R, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 2008; 54:303.
  8. Bochner BH, Dalbagni G, Sjoberg DD, et al. Comparing Open Radical Cystectomy and Robot-assisted Laparoscopic Radical Cystectomy: A Randomized Clinical Trial. Eur Urol 2015; 67:1042.
  9. Solsona E, Iborra I, Collado A, et al. Feasibility of radical transurethral resection as monotherapy for selected patients with muscle invasive bladder cancer. J Urol 2010; 184:475.
  10. Ghahestani SM, Shakhssalim N. Palliative treatment of intractable hematuria in context of advanced bladder cancer: a systematic review. Urol J 2009; 6:149.
  11. Ok JH, Meyers FJ, Evans CP. Medical and surgical palliative care of patients with urological malignancies. J Urol 2005; 174:1177.
  12. Zebic N, Weinknecht S, Kroepfl D. Radical cystectomy in patients aged > or = 75 years: an updated review of patients treated with curative and palliative intent. BJU Int 2005; 95:1211.
  13. Konski A, Feigenberg S, Chow E. Palliative radiation therapy. Semin Oncol 2005; 32:156.