Present and future perspective in the field of bladder cancer

Present and future perspective in the field of bladder cancer

Urinary bladder cancer (BCa) accounts for about 7% of all new cancers in the United States with 81,190 estimated new cases and 17,240 deaths in 2018 (1). Approximately 75% of the new diagnoses BCa will be non-muscle-invasive BCa (NMIBC) (2) affected by recurrence and progression rates of approximately 60% and 20%, respectively (3). Several unmet questions have been raised in the urological community regarding BCa. Recently, the European Association of Urology (EAU) and the European Society of Medical Oncology (ESMO) selected a panel of experts to define important topics in the field of BCa and to propose possible management solution (4,5). In this series on BCa we collected a series of articles treating some of the most important series for the urological community.

The impact of new technologies has changed the way we treat BCa, especially the use of robotic surgery has consistently increased in the last years overtaking in many centers the use of open surgery (6). The use of new technologies may increase survival expectations and quality of life of patients. The importance of an accurate surgical management in patients is pivotal in non-muscle invasive BCa, where transurethral resection (TUR) of the bladder plays an important role in defining pathological specimens and survival outcomes. Similarly, in this regard the impact of local surgery in patients affected by metastatic BCa patients is one of the new studied area in this field (7,8).

Prognostic evaluation and pathologic characterization of the TUR and radical cystectomy (RC) specimen is fundamental in defining oncological outcomes and for defining the optimal treatment. Variant histology can impact survival outcomes and similarly define optimal treatment strategies (9). Biomarker can help to implement new strategies in the field of BCa. The reader of this series can read the last findings on these topics. I would like to thank the editorial office, authors, reviewers and all the readers for their efforts in putting together this series.


Funding: None.


Provenance and Peer Review: This article was commissioned by the editorial office, AME Medical Journal for the series “Bladder Cancer”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at The series “Bladder Cancer” was commissioned by the editorial office without any funding or sponsorship. MM served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of AME Medical Journal from Sep 2019 to Aug 2021. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See:


  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018;68:7-30. [Crossref] [PubMed]
  2. Babjuk M, Böhle A, Burger M, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol 2017;71:447-61. [Crossref] [PubMed]
  3. Herr HW. Tumor progression and survival of patients with high grade, noninvasive papillary (TaG3) bladder tumors: 15-year outcome. J Urol 2000;163:60-1; discussion 61-2. [Crossref] [PubMed]
  4. Horwich A, Babjuk M, Bellmunt J, et al. EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees†. Ann Oncol 2019;30:1697-727. [Crossref] [PubMed]
  5. Witjes JA, Babjuk M, Bellmunt J, et al. EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort†: Under the Auspices of the EAU-ESMO Guidelines Committees. Eur Urol 2020;77:223-50. [Crossref] [PubMed]
  6. Zamboni S, Soria F, Mathieu R, et al. Differences in trends in the use of robot-assisted and open radical cystectomy and changes over time in peri-operative outcomes among selected centres in North America and Europe: an international multicentre collaboration. BJU Int 2019. Epub ahead of print. [Crossref] [PubMed]
  7. Abufaraj M, Gust K, Moschini M, et al. Management of muscle invasive, locally advanced and metastatic urothelial carcinoma of the bladder: a literature review with emphasis on the role of surgery. Transl Androl Urol 2016;5:735-44. [Crossref] [PubMed]
  8. Moschini M, Xylinas E, Zamboni S, et al. Efficacy of Surgery in the Primary Tumor Site for Metastatic Urothelial Cancer: Analysis of an International, Multicenter, Multidisciplinary Database. Eur Urol Oncol 2020;3:94-101. [Crossref] [PubMed]
  9. Abufaraj M, Foerster B, Schernhammer E, et al. Micropapillary Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-analysis of Disease Characteristics and Treatment Outcomes. Eur Urol 2019;75:649-58. [Crossref] [PubMed]
Marco Moschini

Marco Moschini, MD, PhD

Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland.

Received: 30 April 2020; Accepted: 18 May 2020; Published: 25 September 2020.

doi: 10.21037/amj-2019-bc-12

doi: 10.21037/amj-2019-bc-12
Cite this article as: Moschini M. Present and future perspective in the field of bladder cancer. AME Med J 2020;5:25.