Non-muscle-invasive Bladder Cancer

For the 2024 NMIBC Guidelines new and relevant evidence was identified, collated and appraised through a structured assessment of the literature for all sections of the Guidelines. This resulted in the inclusion of 36 updated studies across the Guidelines. Key changes include the addition of:

  • a new category of high-grade recurrence during or after BCG (table 7.2): the BCG-exposed tumour category;
  • updates on the proposed treatment options for late BCG relapses and low grade (LG) recurrence after bacillus Calmette-Guérin (BCG) for primary intermediate-risk bladder cancer in table 7.3;
  • a proposed follow-up schedule based on patient’s risk category in Table 8.2;
  • a new section on patient reported outcome measures and quality indicators for NMIBC (section 9).

In addition, minor adaptions and updates to multiple recommendations have been made and users are advised to review all sections in full. A summary of key recommendation changes include:

  • an update in the evidence and guidelines in section 4.10 on bladder cancer classification;
  • new summary of evidence and recommendations updates in section 5.15 on the transurethral resection of the bladder, biopsies and pathology report;
  • guidelines updates in section 7.10 on adjuvant therapy in TaT1 tumours and for therapy of carcinoma in situ;
  • a new update to the very high risk EAU risk group, in section 7.11 on the guidelines for the
  • treatment of TaT1 tumours and carcinoma in situ according to risk stratification;
  • new updates in section 8.2 on the summary of evidence and recommendations for the follow-up of patients after transurethral resection of the bladder for non-muscle-invasive bladder cancer.