Contemporary management of superficial bladder cancer.

BACKGROUND Bladder cancer is the second most common urologic malignancy after prostate cancer. Superficial bladder cancer presents as a heterogeneous group of tumors with variable biological potential. A significant percentage of patients diagnosed with superficial cancer will have multiple recurrences, and some will progress to invasive disease. METHODS Patients are stratified into low- or high-risk for recurrence and progression. We review the most recent literature regarding intravesical therapy for superficial bladder cancer, and we summarize indications for the use of intravesical agents as well as their efficacy, toxicity, and cost. RESULTS Several intravesical agents are available for the treatment of superficial bladder cancer. Patients may be identified as low- or high-risk for recurrence and progression. High-risk patients benefit from intravesical therapy. CONCLUSIONS Superficial bladder cancer is a heterogeneous group of diseases. Treatment is effective in preventing recurrences and progression in the high-risk group.