ABSTRACT
ABSTRACT Purpose: To describe the current scientific knowledge and clinical experience in low-grade-non-muscle-invasive bladder cancer (LG-NMIBC) patients in challenging scenarios. Materials and Methods: Medline, Embase, Google Scholar, and Cochrane Central were searched until March 2021. Results: A total of 841 studies were identified, and abstracts were analyzed. Twenty-one relevant studies were then identified and reviewed. After all, information was gathered from 16 studies, the authors discussed the specific topics, and expert opinions were also included in the discussion. There have been some studies that can help us to have some insights on how to manage these patients. Very distinctive strategies have been reported in the literature, mainly anecdotally or in small randomized studies. Some of these treatments outlined in the present manuscript include repeated TURBTs, chemoablation, BCG immunoablation, partial cystectomy, radical cystectomy, radiotherapy, chemotherapy, and future perspectives. In the current manuscript, we have combined these strategies in a proposed algorithm. Conclusion: For those LG-NMIBC patients in challenging scenarios, we have found repeated TURBTs, chemoablation, BCG immunoablation, partial cystectomy, radical cystectomy, radiotherapy, and chemotherapy are attractive modalities to treat them effectively. Also, the current manuscript proposes an algorithm to overcome these challenges.
ABSTRACT
The care of patients diagnosed with rare genitourinary tumors have often been compromised by the lack of standardization in the diagnostic evaluation and therapeutic management in significant part due to the lack of regional or national expertise in the management of such malignancies and/or the paucity of information supporting an evidence based approach to these conditions. The GSRGT embraces the involvement of all international countries and colleagues in this effort and in fact we would like to insure under-represented parts of the world have a significant representation and voice within the society. In this regard, we are very pleased to announce the formal establishment and launch of the Global Society of Rare GU Tumors which is solely dedicated to advancing the care for these rare genitourinary tumors through promoting optimal treatment strategies, innovative research, and a comprehensive education platform for patients, families, and the entire healthcare team along with a commitment to patient advocacy. The GSRGT will gather international thought leaders with expertise on the subject matter and we are honored to share the schema of our leadership team and governing council (please see attached). This society was created as an impetus that these rare tumors are poorly studied and constitute a diagnostic and treatment conundrum and that a dedicated commitment to their care and study would be quite impactful in improving patient outcomes and quality of life in addition to fostering opportunities for research collaborations.
El cuidado de los pacientes diagnosticados con tumores genitourinarios raros a menudo se ha visto comprometido por la falta de estandarización en la evaluación diagnóstica y el manejo terapéutico, en gran parte debido a la falta de experiencia regional o nacional en el manejo de estas neoplasias y/o la escasez de información que apoye un enfoque basado en la evidencia para estas condiciones. La GSRGT acepta la participación de todos los países y colegas internacionales en este esfuerzo y, de hecho, nos gustaría asegurarnos de que las partes menos representadas del mundo tengan una representación y una voz significativas dentro de la sociedad. En este sentido, nos complace anunciar el establecimiento formal y el lanzamiento de la Sociedad Global de Tumores Raros de GU, dedicada exclusivamente a mejorar la atención de estos tumores genitourinarios raros mediante la promoción de estrategias de tratamiento óptimas, investigación innovadora y una plataforma de educación integral para pacientes, familias y todo el equipo sanitario, junto con un compromiso con la defensa del paciente. La GSRGT reunirá a líderes de opinión internacionales expertos en la materia y tenemos el honor de compartir el esquema de nuestro equipo directivo y consejo de gobierno (véase adjunto). Esta sociedad se creó con el impulso de que estos tumores raros están poco estudiados y constituyen un enigma de diagnóstico y tratamiento, y que un compromiso dedicado a su cuidado y estudio tendría un gran impacto en la mejora de los resultados y la calidad de vida de los pacientes, además de fomentar oportunidades de colaboración en la investigación.