Factor

Clinical outcome

Reference

Histology

Ÿ Patients with Variant Histology fared the worst (PUS associated with decreased OS).

Ÿ Lower 2-year RR post BCG in patients with Variable Histology.

[4]

[5]

Biomarkers

Ÿ Helpful for stratification.

Ÿ Needs further studies to be included in predictive models.

[7]

[11]

Imaging

Ÿ NBI > WLI in detecting NMIBC including CIS allowing more complete resection.

Ÿ NBI has a higher sensitivity and lower specificity compared to WLI.

Ÿ Fluorescent endoscopy + ALA > WLI in detecting recurrence (39% vs 16%).

Ÿ Hexvix PDD-assisted TUR decrease RR compared to traditional technique (13.6% vs 30%).

[12]

[13]

[17]

[18]

Risk stratification

Ÿ EORTC and CUETO are the two most important risk assessment models

Ÿ Combining EORTC + Ki-67 expression enhance risk stratification for recurrence and progression.

[19]

[23]

TUR

Ÿ Monopolar vs bipolar :pathological advantage, better sampling rate, less operative time

Ÿ Monopolar vs laser resection (no difference in RR).

Ÿ Monopolar vs KTP (no difference in operative time and RR).

[24]

[30]

[31]

Re-TUR

Ÿ 7 studies reported the role of Re-TUR in restaging (50% residual tumor among them 10% - 25% MIBC).

Ÿ Higher 2-year RFS (77% vs 45.8% p: 0.025; No effect on PFS).

Ÿ Some studies showed the possibility of emitting Re-TUR if + muscle on initial resection.

Ÿ Valuable if T1, high grade, more than 3 cm, absence of muscle

Ÿ The effect on survival improvement is debatable.

[34]

[35]

[37]

[40]

Intravesical agents

Ÿ BCG maintenance vs induction only : decreased RR and PR

Ÿ Gemcitabine as a 2^nd line option after BCG.

Ÿ (Gem + BCG) vs BCG alone associated in decreased RR (33.9% vs 20%).

Ÿ MMC vs BCG same efficacy w more SE.

[51]

[53]

[58]