BackTable Tumor Board S03 Ep. 24 Contemporary Diagnostics in NMIBC: Clinical Insights with Dr. Anne Schuckman and Dr. Piyush Agarwal
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Oct 7, 2025 
Dr. Piyush Agarwal, a urologic oncologist specializing in bladder cancer, and Dr. Anne Schuckman, an expert in non-muscle invasive bladder cancer, share groundbreaking insights into bladder cancer diagnostics. They discuss the significance of advanced biomarkers, the role of artificial intelligence, and risk stratification techniques. Topics include practical surveillance strategies tailored to patient needs and the importance of effective communication about recurrence risks. They also touch on future innovations in diagnostics and how technology will enhance patient care.
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Stratify NMIBC Upfront
- Risk-stratify every new NMIBC patient to guide management and surveillance.
- Treat single low-grade lesions as low risk, high-grade as high risk, and large/multifocal recurrent low-grade as intermediate risk.
Prefer Bladder Wash Cytology
- Always send instrumented (barbotage/bladder-wash) cytology rather than voided cytology for better cellular yield.
- Use experienced cytopathologists to minimize excessive 'atypical' calls and improve test utility.
Cytology Is Lab-Dependent
- Cytology performance depends heavily on the reading pathologist's expertise and lab quality.
- Peripheral labs may produce markedly different cytology reads than specialized uro-pathology services.