Overview
Metastatic bladder cancer (MMIBC) refers to bladder cancer that has spread to distant sites. Management decisions are largely based on clinical factors and staging 1.Diagnosis
Staging is preferably performed with enhanced computerized tomography scanning 1.
Variant histologies are increasingly reported and are relevant for treatment and prognosis 1.Management
Radical cystectomy with lymph node dissection is recommended for highest-risk non-muscle-invasive and muscle-invasive nonmetastatic bladder cancer in "fit" patients, preceded by cisplatin-based neoadjuvant chemotherapy 1.Key Recommendations
Staging is preferably done with (enhanced) computerized tomography scanning 1. (Evidence: Expert opinion)
Radical cystectomy with lymph node dissection remains the recommended treatment in highest-risk non-muscle-invasive and muscle-invasive nonmetastatic bladder cancer, preceded by cisplatin-based neoadjuvant chemotherapy for invasive tumors in "fit" patients 1. (Evidence: Expert opinion)
Variant histologies are increasingly reported in invasive bladder cancer and are relevant for treatment and prognosis 1. (Evidence: Expert opinion)References
1 Witjes JA, Bruins HM, Cathomas R, Compérat EM, Cowan NC, Gakis G et al.. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. European urology 2021. link