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The aim of this systematic review was to present available data on diagnostic and therapeutic options in intradiverticular bladder tumour cases. A literature search within the Medline database was conducted in March 2019 with combinations of the following search terms: bladder cancer, bladder tumour, bladder diverticulum, diverticulum, intradiverticular. Seventeen relevant articles were identified. Diagnostic and therapeutic options for intradiverticular bladder tumour follow the general management of bladder cancer patients. The most important differences include a higher rate of non-urothelial histology, higher rate of invasive cancers (stage T1 and higher), no stage T2 disease due to lack of a muscularis propria layer and potential role of partial cystectomy or diverticulectomy in the treatment. Among cystectomized patients, the survival is comparable to general bladder cancer patients after cystectomy. Data on accuracy of imaging and endoscopy in diagnosing intradiverticular bladder tumour are poor. There is no study comparing different treatment modalities in intradiverticular bladder tumour patients. Limitations of this review include low number and low evidence level of available studies, as well as low number and heterogeneity of enrolled subjects. Available literature data cannot be the basis for clinical recommendations in intradiverticular bladder tumour cases. While bladder cancer is the most common urinary tract malignancy and at least 1% of cases are intradiverticular, further research in this field is justified.

Introduction: The study aimed to analyze the influence of restaging transurethral resection of bladder tumor (reTURB) timing on outcomes in patients receiving Bacillus Calmette-Guerin (BCG) immunotherapy. Material and Methods: This retrospective study enrolled 491 patients with bladder cancer receiving BCG intravesical therapy between 1998 and 2016. All patients were followed up for at least 12 months and received at least 7 BCG instillations. The patients were analyzed in terms of recurrence free, progression free, and cancer specific survival (CSS). Results: Median follow-up was 57 months (12–257 months). The risk for all analyzed clinical events was higher in patients who underwent reTURB after 6 weeks from primary TURB. After the change point of 57 days after primary resection, further delay was not associated with increased risk of recurrence and progression. The time limit for CSS was 76 days. With every 1 more day of time interval between TURB and reTURB, the risk of each clinical event in follow-up increased by 4%. Conclusions: There is no benefit of the reTURB performed after 8 weeks from primary TURB. Optimal timing of reTURB is from 2 to 6 weeks after initial TURB. However, even within this time frame, the sooner the procedure is performed, the risk of recurrence, progression, or cancer-specific death is lower.

Purpose: To evaluate if there are differences in toxicity and efficacy between different Bacillus Calmette-Guerin (BCG) stains used for intravesical immunotherapy in patients with non-muscle invasive bladder cancer. Methods: We retrospectively analysed a group of 844 patients who received TICE, RIVM and Moreau BCG strains. The allocation of the strain to each patient was random, stemming from differences in supply and distribution. The patients were analysed in terms of toxicity, recurrence-free (RFS), progression-free (PFS), cancer-specific (CSS) and overall survival (OS). Results: In the survival analysis, statistical significance was not reached in any tumour group for any clinical event. TICE caused more local and mild adverse effects and severe complications were mainly associated with RIVM strain. In a group in which the strain was changed during the course of the therapy, significantly more severe complications were observed and, in most of these cases, complications appeared right after the strain change. Conclusions: There were no differences in terms of RFS, PFS, CSS and OS after use of TICE, RIVM and Moreau strains. The complication profile differed statistically between used strains with TICE causing mostly mild complications. Also, strain change during the therapy course was associated with the increased risk of moderate to severe toxicity occurrence.

Along with significant advances in prostate cancer biology research, we also observe the rapid development of modern diagnostic tests. New biomarkers are derived to detect disease while it is organ-confined to stratify the risk and to aid clinical decision-making. Majority of these tools have already been validated clinically, but only a few have received premarket clearance and administration approval. Superiority of novel tests is visible not only in improved detection accuracy but predominantly in the assessment of tumour aggressiveness and selection of patients eligible for conservative management. Two factors limiting the clinical implementation of validated biomarker candidates are costs and local availability. For these reasons, currently, their true clinical role starts after routine screening with prostate-specific antigen test. With this review of prostate cancer biomarkers, we attempted to draw general conclusions on clinical perspectives of these novel tools.

Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy in bladder cancer patients with asymptomatic bacteriuria (ABU) remains a matter of debate. The aim of this systematic review was to present available evidence on the safety and efficacy of BCG immunotherapy in patients with ABU. A literature search within the Medline and the Embase databases was conducted with the following search terms: adverse events, bacteriuria, BCG, bladder cancer, cystitis, infection, pyuria, side effects and urinary tract infection (UTI). Sixteen relevant original articles were identified, including 6 articles directly presenting the safety or efficacy of BCG therapy in patients with ABU. None of them was a randomized controlled trial. Intravesical BCG instillations in patients with ABU were not associated with the increased risk of symptomatic UTI and did not affect negatively the recurrence- or progression-free survival. Routine urine analysis before BCG instillation created increased cost and potentially unnecessary delays in BCG therapy. ABU does not affect negatively the safety and efficacy of intravesical BCG immunotherapy. There is no evidence to support routine screening and treatment of ABU in patients scheduled for intravesical BCG instillations due to bladder cancer. However, this issue was not addressed adequately and needs further research.