Recommendation ID
Is primary radical cystectomy more effective than primary intravesical BCG (Bacille Calmette-Guérin) in high risk non-muscle-invasive bladder cancer, in terms of quality of life and cancer-specific outcomes?
Any explanatory notes
(if applicable)
Options for people with high-risk non-muscle-invasive bladder cancer include cystoscopy surveillance, BCG immunotherapy or radical surgery. To date, these have not been directly compared across the same population to understand their relative benefits. Bladder-sparing approaches avoid major surgery, but have a greater risk of cancer progression. The potential advantage of bladder-sparing approaches compared with cystectomy in maintaining quality of life may be offset by continuing concern about cancer progression and morbidity from treatment. Primary cystectomy may improve survival; however, it has high short-term risks and life-changing consequences. It will be overtreatment for those people whose cancer would not have progressed.

Source guidance details

Comes from guidance
Bladder cancer: diagnosis and management
Date issued
February 2015

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 23/04/2015