This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Bladder Cancer focuses on the clinical presentation and workup of suspected bladder cancer, treatment of non–muscle-invasive urothelial bladder cancer, and treatment of metastatic urothelial bladder cancer because important updates have recently been made to these sections. Some important updates include recommendations for optimal treatment of non–muscle-invasive bladder cancer in the event of a bacillus Calmette-Guérin (BCG) shortage and details about biomarker testing for advanced or metastatic disease. The systemic therapy recommendations for second-line or subsequent therapies have also been revised. Treatment and management of muscle-invasive, nonmetastatic disease is covered in the complete version of the NCCN Guidelines for Bladder Cancer available at NCCN.org. Additional topics covered in the complete version include treatment of nonurothelial histologies and recommendations for nonbladder urinary tract cancers such as upper tract urothelial carcinoma, urothelial carcinoma of the prostate, and primary carcinoma of the urethra.
Individual Disclosures for the NCCN Bladder Cancer Panel
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HuJ, ChenJB, CuiY, et al.. Association of metformin intake with bladder cancer risk and oncologic outcomes in type 2 diabetes mellitus patients: a systematic review and meta-analysis. Medicine (Baltimore)2018;97:e11596.
HuJ, ChenJB, CuiY, . Association of metformin intake with bladder cancer risk and oncologic outcomes in type 2 diabetes mellitus patients: a systematic review and meta-analysis. Medicine (Baltimore) 2018;97:e11596.10.1097/MD.000000000001159630045293)| false
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WeltyCJ, WrightJL, HotalingJM, . Persistence of urothelial carcinoma of the bladder risk among former smokers: results from a contemporary, prospective cohort study. Urol Oncol 2014;32:25.e21–25.e25.10.1016/j.urolonc.2012.09.001)| false
MessingEM, TangenCM, LernerSP, et al.. Effect of intravesical instillation of gemcitabine vs saline immediately following resection of suspected low-grade non–muscle-invasive bladder cancer on tumor recurrence: SWOG S0337 randomized clinical trial. JAMA2018;319:1880–1888.
MessingEM, TangenCM, LernerSP, . Effect of intravesical instillation of gemcitabine vs saline immediately following resection of suspected low-grade non–muscle-invasive bladder cancer on tumor recurrence: SWOG S0337 randomized clinical trial. JAMA 2018;319:1880–1888.10.1001/jama.2018.465729801011)| false
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BosschieterJ, NieuwenhuijzenJA, van GinkelT, . Value of an immediate intravesical instillation of mitomycin C in patients with non-muscle-invasive bladder cancer: A prospective multicentre randomised study in 2243 patients. Eur Urol 2018;73:226–232.2870553910.1016/j.eururo.2017.06.038)| false
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SylvesterRJ, OosterlinckW, HolmangS, . Systematic review and individual patient data meta-analysis of randomized trials comparing a single immediate instillation of chemotherapy after transurethral resection with transurethral resection alone in patients with stage pTa-pT1 urothelial carcinoma of the bladder: Which patients benefit from the instillation?Eur Urol 2016;69:231–244.26091833)| false
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SylvesterRJ, van der MeijdenAP, OosterlinckW, . Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006;49:466–465, discussion 475–477.10.1016/j.eururo.2005.12.03116442208)| false
SchmidbauerJ, WitjesF, SchmellerN, et al.. Improved detection of urothelial carcinoma in situ with hexaminolevulinate fluorescence cystoscopy. J Urol2004;171:135–138.
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JochamD, WitjesF, WagnerS, . Improved detection and treatment of bladder cancer using hexaminolevulinate imaging: a prospective, phase III multicenter study. J Urol 2005;174:862–866., discussion 866.1609397110.1097/01.ju.0000169257.19841.2a)| false
GrossmanHB, GomellaL, FradetY, et al.. A phase III, multicenter comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of superficial papillary lesions in patients with bladder cancer. J Urol2007;178:62–67.
GrossmanHB, GomellaL, FradetY, . A phase III, multicenter comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of superficial papillary lesions in patients with bladder cancer. J Urol 2007;178:62–67.10.1016/j.juro.2007.03.03417499283)| false
FradetY, GrossmanHB, GomellaL, et al.. A comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of carcinoma in situ in patients with bladder cancer: a phase III, multicenter study. J Urol2007;178:68–73., discussion 73.
FradetY, GrossmanHB, GomellaL, . A comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of carcinoma in situ in patients with bladder cancer: a phase III, multicenter study. J Urol 2007;178:68–73., discussion 73.1749929110.1016/j.juro.2007.03.028)| false
HermannGG, MogensenK, CarlssonS, et al.. Fluorescence-guided transurethral resection of bladder tumours reduces bladder tumour recurrence due to less residual tumour tissue in Ta/T1 patients: a randomized two-centre study. BJU Int2011;108(8b):E297–E303.
HermannGG, MogensenK, CarlssonS, . Fluorescence-guided transurethral resection of bladder tumours reduces bladder tumour recurrence due to less residual tumour tissue in Ta/T1 patients: a randomized two-centre study. BJU Int 2011;108(8b):E297–E303.2141412510.1111/j.1464-410X.2011.10090.x)| false
YuanH, QiuJ, LiuL, et al.. Therapeutic outcome of fluorescence cystoscopy guided transurethral resection in patients with non-muscle invasive bladder cancer: a meta-analysis of randomized controlled trials. PLoS One2013;8:e74142.
YuanH, QiuJ, LiuL, . Therapeutic outcome of fluorescence cystoscopy guided transurethral resection in patients with non-muscle invasive bladder cancer: a meta-analysis of randomized controlled trials. PLoS One 2013;8:e74142.10.1371/journal.pone.0074142)| false
BurgerM, GrossmanHB, DrollerM, et al.. Photodynamic diagnosis of non-muscle-invasive bladder cancer with hexaminolevulinate cystoscopy: a meta-analysis of detection and recurrence based on raw data. Eur Urol2013;64:846–854.
BurgerM, GrossmanHB, DrollerM, . Photodynamic diagnosis of non-muscle-invasive bladder cancer with hexaminolevulinate cystoscopy: a meta-analysis of detection and recurrence based on raw data. Eur Urol 2013;64:846–854.2360240610.1016/j.eururo.2013.03.059)| false
RinkM, BabjukM, CattoJW, et al.. Hexyl aminolevulinate-guided fluorescence cystoscopy in the diagnosis and follow-up of patients with non-muscle-invasive bladder cancer: a critical review of the current literature. Eur Urol2013;64:624–638.
RinkM, BabjukM, CattoJW, . Hexyl aminolevulinate-guided fluorescence cystoscopy in the diagnosis and follow-up of patients with non-muscle-invasive bladder cancer: a critical review of the current literature. Eur Urol 2013;64:624–638.2390666910.1016/j.eururo.2013.07.007)| false
KamatAM, CooksonM, WitjesJA, et al.. The impact of blue light cystoscopy with hexaminolevulinate (HAL) on progression of bladder cancer - a new analysis. Bladder Cancer2016;2:273–278.
KamatAM, CooksonM, WitjesJA, . The impact of blue light cystoscopy with hexaminolevulinate (HAL) on progression of bladder cancer - a new analysis. Bladder Cancer 2016;2:273–278.2737614610.3233/BLC-160048)| false
CaubergEC, KloenS, VisserM, et al.. Narrow band imaging cystoscopy improves the detection of non-muscle-invasive bladder cancer. Urology2010;76:658–663.
ChenG, WangB, LiH, et al.. Applying narrow-band imaging in complement with white-light imaging cystoscopy in the detection of urothelial carcinoma of the bladder. Urol Oncol2013;31:475–479.
ChenG, WangB, LiH, . Applying narrow-band imaging in complement with white-light imaging cystoscopy in the detection of urothelial carcinoma of the bladder. Urol Oncol 2013;31:475–479.10.1016/j.urolonc.2011.02.00922079940)| false
GeavleteB, JecuM, MultescuR, et al.. Narrow-band imaging cystoscopy in non-muscle-invasive bladder cancer: a prospective comparison to the standard approach. Ther Adv Urol2012;4:211–217.
GeavleteB, JecuM, MultescuR, . Narrow-band imaging cystoscopy in non-muscle-invasive bladder cancer: a prospective comparison to the standard approach. Ther Adv Urol 2012;4:211–217.2302470310.1177/1756287212454181)| false
ShenYJ, ZhuYP, YeDW, et al.. Narrow-band imaging flexible cystoscopy in the detection of primary non-muscle invasive bladder cancer: a “second look” matters?Int Urol Nephrol2012;44:451–457.
TatsugamiK, KuroiwaK, KamotoT, et al.. Evaluation of narrow-band imaging as a complementary method for the detection of bladder cancer. J Endourol2010;24:1807–1811.
TatsugamiK, KuroiwaK, KamotoT, . Evaluation of narrow-band imaging as a complementary method for the detection of bladder cancer. J Endourol 2010;24:1807–1811.2070772710.1089/end.2010.0055)| false
NaselliA, IntroiniC, TimossiL, et al.. A randomized prospective trial to assess the impact of transurethral resection in narrow band imaging modality on non-muscle-invasive bladder cancer recurrence. Eur Urol2012;61:908–913.
NaselliA, IntroiniC, TimossiL, . A randomized prospective trial to assess the impact of transurethral resection in narrow band imaging modality on non-muscle-invasive bladder cancer recurrence. Eur Urol 2012;61:908–913.2228085510.1016/j.eururo.2012.01.018)| false
NaitoS, AlgabaF, BabjukM, et al.. The Clinical Research Office of the Endourological Society (CROES) multicentre randomised trial of narrow band imaging-assisted transurethral resection of bladder tumour (TURBT) versus conventional white light imaging-sssisted TURBT in primary non-muscle-invasive bladder cancer patients: Trial protocol and 1-year results. Eur Urol2016;70:506–515.
NaitoS, AlgabaF, BabjukM, . The Clinical Research Office of the Endourological Society (CROES) multicentre randomised trial of narrow band imaging-assisted transurethral resection of bladder tumour (TURBT) versus conventional white light imaging-sssisted TURBT in primary non-muscle-invasive bladder cancer patients: Trial protocol and 1-year results. Eur Urol 2016;70:506–515.27117749)| false
XiongY, LiJ, MaS, et al.. A meta-analysis of narrow band imaging for the diagnosis and therapeutic outcome of non-muscle invasive bladder cancer. PLoS One2017;12:e0170819.
XiongY, LiJ, MaS, . A meta-analysis of narrow band imaging for the diagnosis and therapeutic outcome of non-muscle invasive bladder cancer. PLoS One 2017;12:e0170819.2819248110.1371/journal.pone.0170819)| false
KangW, CuiZ, ChenQ, et al.. Narrow band imaging-assisted transurethral resection reduces the recurrence risk of non-muscle invasive bladder cancer: a systematic review and meta-analysis. Oncotarget2017;8:23880–23890.
HerrHW, DonatSM. A comparison of white-light cystoscopy and narrow-band imaging cystoscopy to detect bladder tumour recurrences. BJU Int2008;102:1111–1114.
HerrHW, DonatSM. A comparison of white-light cystoscopy and narrow-band imaging cystoscopy to detect bladder tumour recurrences. BJU Int 2008;102:1111–1114.10.1111/j.1464-410X.2008.07846.x18778359)| false
SylvesterRJ, van der MeijdenAP, WitjesJA, et al.. Bacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials. J Urol2005;174:86–91., discussion 91–92.
SylvesterRJ, van der MeijdenAP, WitjesJA, . Bacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials. J Urol 2005;174:86–91., discussion 91–92.10.1097/01.ju.0000162059.64886.1c15947584)| false
BöhleA, JochamD, BockPR. Intravesical bacillus Calmette-Guerin versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxicity. J Urol2003;169:90–95.
BöhleA, JochamD, BockPR. Intravesical bacillus Calmette-Guerin versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxicity. J Urol 2003;169:90–95.10.1016/S0022-5347(05)64043-812478111)| false
HanRF, PanJG. Can intravesical bacillus Calmette-Guérin reduce recurrence in patients with superficial bladder cancer? A meta-analysis of randomized trials. Urology2006;67:1216–1223.
HanRF, PanJG. Can intravesical bacillus Calmette-Guérin reduce recurrence in patients with superficial bladder cancer? A meta-analysis of randomized trials. Urology 2006;67:1216–1223.1676518210.1016/j.urology.2005.12.014)| false
ShelleyMD, KynastonH, CourtJ, et al.. A systematic review of intravesical bacillus Calmette-Guérin plus transurethral resection vs transurethral resection alone in Ta and T1 bladder cancer. BJU Int2001;88:209–216.
ShelleyMD, KynastonH, CourtJ, . A systematic review of intravesical bacillus Calmette-Guérin plus transurethral resection vs transurethral resection alone in Ta and T1 bladder cancer. BJU Int 2001;88:209–216.10.1046/j.1464-410x.2001.02306.x11488731)| false
ShelleyMD, WiltTJ, CourtJ, et al.. Intravesical bacillus Calmette-Guérin is superior to mitomycin C in reducing tumour recurrence in high-risk superficial bladder cancer: a meta-analysis of randomized trials. BJU Int2004;93:485–490.
ShelleyMD, WiltTJ, CourtJ, . Intravesical bacillus Calmette-Guérin is superior to mitomycin C in reducing tumour recurrence in high-risk superficial bladder cancer: a meta-analysis of randomized trials. BJU Int 2004;93:485–490.1500871410.1111/j.1464-410X.2003.04655.x)| false
MalmströmPU, SylvesterRJ, CrawfordDE, et al.. An individual patient data meta-analysis of the long-term outcome of randomised studies comparing intravesical mitomycin C versus bacillus Calmette-Guérin for non-muscle-invasive bladder cancer. Eur Urol2009;56:247–256.
MalmströmPU, SylvesterRJ, CrawfordDE, . An individual patient data meta-analysis of the long-term outcome of randomised studies comparing intravesical mitomycin C versus bacillus Calmette-Guérin for non-muscle-invasive bladder cancer. Eur Urol 2009;56:247–256.10.1016/j.eururo.2009.04.03819409692)| false
JärvinenR, KaasinenE, SankilaA, et al.. Long-term efficacy of maintenance bacillus Calmette-Guérin versus maintenance mitomycin C instillation therapy in frequently recurrent TaT1 tumours without carcinoma in situ: a subgroup analysis of the prospective, randomised FinnBladder I study with a 20-year follow-up. Eur Urol2009;56:260–265.
JärvinenR, KaasinenE, SankilaA, . Long-term efficacy of maintenance bacillus Calmette-Guérin versus maintenance mitomycin C instillation therapy in frequently recurrent TaT1 tumours without carcinoma in situ: a subgroup analysis of the prospective, randomised FinnBladder I study with a 20-year follow-up. Eur Urol 2009;56:260–265.19395154)| false
GonteroP, OderdaM, MehnertA, et al.. The impact of intravesical gemcitabine and 1/3 dose bacillus Calmette-Guérin instillation therapy on the quality of life in patients with nonmuscle invasive bladder cancer: results of a prospective, randomized, phase II trial. J Urol2013;190:857–862.
GonteroP, OderdaM, MehnertA, . The impact of intravesical gemcitabine and 1/3 dose bacillus Calmette-Guérin instillation therapy on the quality of life in patients with nonmuscle invasive bladder cancer: results of a prospective, randomized, phase II trial. J Urol 2013;190:857–862.10.1016/j.juro.2013.03.09723545101)| false
SylvesterRJ, BrausiMA, KirkelsWJ, et al.. Long-term efficacy results of EORTC genito-urinary group randomized phase 3 study 30911 comparing intravesical instillations of epirubicin, bacillus Calmette-Guérin, and bacillus Calmette-Guérin plus isoniazid in patients with intermediate- and high-risk stage Ta T1 urothelial carcinoma of the bladder. Eur Urol2010;57:766–773.
SylvesterRJ, BrausiMA, KirkelsWJ, . Long-term efficacy results of EORTC genito-urinary group randomized phase 3 study 30911 comparing intravesical instillations of epirubicin, bacillus Calmette-Guérin, and bacillus Calmette-Guérin plus isoniazid in patients with intermediate- and high-risk stage Ta T1 urothelial carcinoma of the bladder. Eur Urol 2010;57:766–773.20034729)| false
DuchekM, JohanssonR, JahnsonS, et al.. Bacillus Calmette-Guérin is superior to a combination of epirubicin and interferon-alpha2b in the intravesical treatment of patients with stage T1 urinary bladder cancer: a prospective, randomized, Nordic study. Eur Urol2010;57:25–31.
DuchekM, JohanssonR, JahnsonS, . Bacillus Calmette-Guérin is superior to a combination of epirubicin and interferon-alpha2b in the intravesical treatment of patients with stage T1 urinary bladder cancer: a prospective, randomized, Nordic study. Eur Urol 2010;57:25–31.1981961710.1016/j.eururo.2009.09.038)| false
LammDL, BlumensteinBA, CrissmanJD, et al.. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol2000;163:1124–1129.
LammDL, BlumensteinBA, CrissmanJD, . Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol 2000;163:1124–1129.10.1016/S0022-5347(05)67707-5)| false
EhdaieB, SylvesterR, HerrHW. Maintenance bacillus Calmette-Guérin treatment of non-muscle-invasive bladder cancer: a critical evaluation of the evidence. Eur Urol2013;64:579–585.
OddensJ, BrausiM, SylvesterR, et al.. Final results of an EORTC-GU cancers group randomized study of maintenance bacillus Calmette-Guérin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance. Eur Urol2013;63:462–472.
OddensJ, BrausiM, SylvesterR, . Final results of an EORTC-GU cancers group randomized study of maintenance bacillus Calmette-Guérin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance. Eur Urol 2013;63:462–472.10.1016/j.eururo.2012.10.03923141049)| false
BöhleA, BockPR. Intravesical bacille Calmette-Guérin versus mitomycin C in superficial bladder cancer: formal meta-analysis of comparative studies on tumor progression. Urology2004;63:682–686, discussion 686–687.
BöhleA, BockPR. Intravesical bacille Calmette-Guérin versus mitomycin C in superficial bladder cancer: formal meta-analysis of comparative studies on tumor progression. Urology 2004;63:682–686, discussion 686–687.1507287910.1016/j.urology.2003.11.049)| false
SylvesterRJ, van der MEIJDENAP, LammDL. Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol2002;168:1964–1970.
SylvesterRJ, van der MEIJDENAP, LammDL. Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol 2002;168:1964–1970.10.1016/S0022-5347(05)64273-512394686)| false
van der MeijdenAP, SylvesterRJ, OosterlinckW, et al.. Maintenance bacillus Calmette-Guerin for Ta T1 bladder tumors is not associated with increased toxicity: results from a European Organisation for Research and Treatment of Cancer genito-urinary group phase III trial. Eur Urol2003;44:429–434.
van der MeijdenAP, SylvesterRJ, OosterlinckW, . Maintenance bacillus Calmette-Guerin for Ta T1 bladder tumors is not associated with increased toxicity: results from a European Organisation for Research and Treatment of Cancer genito-urinary group phase III trial. Eur Urol 2003;44:429–434.10.1016/S0302-2838(03)00357-9)| false
ColombelM, SaintF, ChopinD, et al.. The effect of ofloxacin on bacillus Calmette-Guerin induced toxicity in patients with superficial bladder cancer: results of a randomized, prospective, double-blind, placebo controlled, multicenter study. J Urol2006;176:935–939.
ColombelM, SaintF, ChopinD, . The effect of ofloxacin on bacillus Calmette-Guerin induced toxicity in patients with superficial bladder cancer: results of a randomized, prospective, double-blind, placebo controlled, multicenter study. J Urol 2006;176:935–939.10.1016/j.juro.2006.04.10416890660)| false
DamianoR, De SioM, QuartoG, et al.. Short-term administration of prulifloxacin in patients with nonmuscle-invasive bladder cancer: an effective option for the prevention of bacillus Calmette-Guérin-induced toxicity?BJU Int2009;104:633–639.
DamianoR, De SioM, QuartoG, . Short-term administration of prulifloxacin in patients with nonmuscle-invasive bladder cancer: an effective option for the prevention of bacillus Calmette-Guérin-induced toxicity?BJU Int 2009;104:633–639.1929841210.1111/j.1464-410X.2009.08469.x)| false
BrausiM, OddensJ, SylvesterR, et al.. Side effects of bacillus Calmette-Guérin (BCG) in the treatment of intermediate- and high-risk Ta, T1 papillary carcinoma of the bladder: results of the EORTC genito-urinary cancers group randomised phase 3 study comparing one-third dose with full dose and 1 year with 3 years of maintenance BCG. Eur Urol2014;65:69–76.
BrausiM, OddensJ, SylvesterR, . Side effects of bacillus Calmette-Guérin (BCG) in the treatment of intermediate- and high-risk Ta, T1 papillary carcinoma of the bladder: results of the EORTC genito-urinary cancers group randomised phase 3 study comparing one-third dose with full dose and 1 year with 3 years of maintenance BCG. Eur Urol 2014;65:69–76.23910233)| false
LebretT, BohinD, KassardjianZ, et al.. Recurrence, progression and success in stage Ta grade 3 bladder tumors treated with low dose bacillus Calmette-Guerin instillations. J Urol2000;163:63–67.
Martínez-PiñeiroJA, Martínez-PiñeiroL, SolsonaE, et al.. Has a 3-fold decreased dose of bacillus Calmette-Guerin the same efficacy against recurrences and progression of T1G3 and Tis bladder tumors than the standard dose? Results of a prospective randomized trial. J Urol2005;174:1242–1247.
Martínez-PiñeiroJA, Martínez-PiñeiroL, SolsonaE, . Has a 3-fold decreased dose of bacillus Calmette-Guerin the same efficacy against recurrences and progression of T1G3 and Tis bladder tumors than the standard dose? Results of a prospective randomized trial. J Urol 2005;174:1242–1247.10.1097/01.ju.0000173919.28835.aa)| false
MugiyaS, OzonoS, NagataM, et al.. Long-term outcome of a low-dose intravesical bacillus Calmette-Guerin therapy for carcinoma in situ of the bladder: results after six successive instillations of 40 mg BCG. Jpn J Clin Oncol2005;35:395–399.
MugiyaS, OzonoS, NagataM, . Long-term outcome of a low-dose intravesical bacillus Calmette-Guerin therapy for carcinoma in situ of the bladder: results after six successive instillations of 40 mg BCG. Jpn J Clin Oncol 2005;35:395–399.1597606510.1093/jjco/hyi111)| false
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BandariJ, MagantyA, MacLeodLC, . Manufacturing and the market: rationalizing the shortage of bacillus Calmette-Guérin. Eur Urol Focus 2018;4:481–484.3000599710.1016/j.euf.2018.06.018)| false
Shortage Notice BCG. American Urological Association (AUA), American Association of Clinical Urologists (AACU), Bladder Cancer Advocacy Network (BCAN), Society of Urologic Oncology (SUO), the Large Urology Group Practice Association (LUGPA), and the Urology Care Foundation (UCF); 2019. Available at: https://www.auanet.org/bcg-shortage-notice. Accessed March 4, 2019.
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Di LorenzoG, PerdonàS, DamianoR, et al.. Gemcitabine versus bacille Calmette-Guérin after initial bacille Calmette-Guérin failure in non-muscle-invasive bladder cancer: a multicenter prospective randomized trial. Cancer2010;116:1893–1900.
Di LorenzoG, PerdonàS, DamianoR, . Gemcitabine versus bacille Calmette-Guérin after initial bacille Calmette-Guérin failure in non-muscle-invasive bladder cancer: a multicenter prospective randomized trial. Cancer 2010;116:1893–1900.10.1002/cncr.24914)| false
FriedrichMG, PichlmeierU, SchwaiboldH, et al.. Long-term intravesical adjuvant chemotherapy further reduces recurrence rate compared with short-term intravesical chemotherapy and short-term therapy with Bacillus Calmette-Guérin (BCG) in patients with non-muscle-invasive bladder carcinoma. Eur Urol2007;52:1123–1129.
ChouR, SelphS, BuckleyDI, et al.. Intravesical therapy for the treatment of nonmuscle invasive bladder cancer: a systematic review and meta-analysis. J Urol2017;197:1189–1199.
ChouR, SelphS, BuckleyDI, . Intravesical therapy for the treatment of nonmuscle invasive bladder cancer: a systematic review and meta-analysis. J Urol 2017;197:1189–1199.10.1016/j.juro.2016.12.09028027868)| false
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