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Adjuvant treatment with intravesical therapies e.g. Mitomycin C, BCG should be determined according to risk stratification.

Risk group Definition Treatment recommendation
Low

All of the following:

Primary
Solitary
Ta
Low grade
< 3 cm
No carcinoma in-situ (CIS)

Single dose intravesical chemotherapy within 24 hours of TURBT

or

Observation

Intermediate All tumours not defined in the two adjacent categories (between the category of low and high risk)

Single dose of intravesical chemotherapy within 24 hours of TURBT

PLUS

Intravesical BCG

or

Full-dose intravesical chemotherapy

High

Any of the following:

T1 tumour
High grade tumour
Carcinoma in-situ (CIS)
Multiple and recurrent and large (> 3 cm) low grade tumours

Single dose of intravesical chemotherapy within 24 hours of TURBT

PLUS

Intravesical BCG

Adapted from the European Association of Urology guidelinesr

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https://www.eviq.org.au/p/3052

15 Oct 2019