Non-muscle-invasive vs muscle-invasive bladder cancer (NMIBC / MIBC)
Bladder cancer is divided by whether it has grown into the bladder's muscle wall. Before that, it is treated inside the bladder; after, the bladder is usually removed or irradiated.
NMIBC (~75% at diagnosis: Ta, T1, CIS) is managed with TURBT and intravesical therapy, stratified as low, intermediate, or high risk. MIBC (T2-T4) needs radical cystectomy or trimodality bladder preservation, now with perioperative systemic therapy (NIAGARA, EV-303/304). Metastatic disease is treated systemically. Upper-tract urothelial carcinoma (renal pelvis, ureter) shares biology and most drugs.
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