{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:12:15Z","timestamp":1793146335880,"version":"4.5.0"},"reference-count":70,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Bladder cancer (BC) is the tenth most common cause of cancer worldwide and is the thirteenth leading cause of cancer mortality. The non-muscle invasive (NMI) variant represents 75% of cases and has a mortality rate of less than 1%; however, it has a high recurrence rate. The gold standard of management is transurethral resection in the case of new lesions. However, this is associated with significant morbidity and costs, so the reduction of these procedures would contribute to reducing complications, morbidity, and the burden to the health system associated with therapy. In this clinical scenario, strategies such as active surveillance have emerged that propose to manage low-risk BC with follow-up; however, due to the low evidence available, this is a strategy that is underutilized by clinicians. On the other hand, in the era of biomarkers, it is increasingly known how to use them as a tool in BC. Therefore, the aim of this review is to provide to clinical practitioners the evidence available to date on AS and the potential role of biomarkers in this therapeutic strategy in patients with low-grade\/risk NMIBC. This is the first review linking use of biomarkers and active surveillance, including 29 articles.<\/jats:p>","DOI":"10.3390\/curroncol31040163","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T11:09:20Z","timestamp":1712920160000},"page":"2201-2220","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Active Surveillance in Non-Muscle Invasive Bladder Cancer, the Potential Role of Biomarkers: A Systematic Review"],"prefix":"10.3390","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0411-0672","authenticated-orcid":false,"given":"Diego","family":"Parrao","sequence":"first","affiliation":[{"name":"School of Medicine, University of O\u2019Higgins, Rancagua 282000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3824-4129","authenticated-orcid":false,"given":"Nemecio","family":"Lizana","sequence":"additional","affiliation":[{"name":"School of Medicine, University of O\u2019Higgins, Rancagua 282000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina","family":"Saavedra","sequence":"additional","affiliation":[{"name":"School of Medicine, University of O\u2019Higgins, Rancagua 282000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2146-5677","authenticated-orcid":false,"given":"Mat\u00edas","family":"Larra\u00f1aga","sequence":"additional","affiliation":[{"name":"Department of Urology, Libertador Bernardo O\u2019Higgins Regional Hospital, Rancagua 282000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina B.","family":"Lindsay","sequence":"additional","affiliation":[{"name":"Research Department, Libertador Bernardo O\u2019Higgins Regional Hospital, Rancagua 282000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio F.","family":"San Francisco","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8581-7658","authenticated-orcid":false,"given":"Juan Crist\u00f3bal","family":"Bravo","sequence":"additional","affiliation":[{"name":"Department of Urology, Libertador Bernardo O\u2019Higgins Regional Hospital, Rancagua 282000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1038\/s41572-023-00468-9","article-title":"Bladder cancer","volume":"9","author":"Hansel","year":"2023","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"832835","DOI":"10.3389\/fonc.2022.832835","article-title":"Xpert Bladder Cancer Monitor May Avoid Cystoscopies in Patients Under \u201cActive Surveillance\u201d for Recurrent Bladder Cancer (BIAS Project): Longitudinal Cohort Study","volume":"12","author":"Fasulo","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.euo.2021.05.002","article-title":"Long-term Follow-up and Factors Associated with Active Surveillance Failure for Patients with Non\u2013muscle-invasive Bladder Cancer: The Bladder Cancer Italian Active Surveillance (BIAS) Experience","volume":"5","author":"Contieri","year":"2022","journal-title":"Eur. Urol. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hu, H., Zhou, M., Yang, B., Zhou, S., Liu, Z., and Zhang, J. (2022). A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer. J. Clin. Med., 11.","DOI":"10.3390\/jcm11175049"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3056","DOI":"10.21037\/tau.2019.09.38","article-title":"Transurethral resection of bladder tumour (TURBT)","volume":"9","author":"Kim","year":"2020","journal-title":"Transl. Androl. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"232","DOI":"10.4103\/0970-1591.185104","article-title":"Grading of complications of transurethral resection of bladder tumor using Clavien\u2013Dindo classification system","volume":"32","author":"Bansal","year":"2016","journal-title":"Indian J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1111\/iju.15338","article-title":"Urinary markers for bladder cancer diagnosis: A review of current status and future challenges","volume":"31","author":"Tomiyama","year":"2024","journal-title":"Int. J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1007\/s00345-018-2550-x","article-title":"Evaluating the cost of surveillance for non-muscle-invasive bladder cancer: An analysis based on risk categories","volume":"37","author":"Mossanen","year":"2019","journal-title":"World J. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100369","DOI":"10.1016\/j.ctarc.2021.100369","article-title":"Active surveillance for non-muscle invasive bladder cancer: A systematic review and pooled-analysis","volume":"27","author":"Petrelli","year":"2021","journal-title":"Cancer Treat Res. Commun."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1097\/01.ju.0000076621.71247.6c","article-title":"Expectant Management of Small, Recurrent, Noninvasive Papillary Bladder Tumors","volume":"170","author":"Soloway","year":"2003","journal-title":"J. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"802","DOI":"10.21037\/tau-23-124","article-title":"Bladder-sparing approaches for muscle invasive bladder cancer: A narrative review of current evidence and future perspectives","volume":"12","author":"Fan","year":"2023","journal-title":"Transl. Androl. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.euf.2023.03.025","article-title":"When and How to Perform Active Surveillance for Low-risk Non\u2013muscle-invasive Bladder Cancer","volume":"9","author":"Contieri","year":"2023","journal-title":"Eur. Urol. Focus."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/MOU.0000000000001028","article-title":"Active surveillance for non-muscle-invasive bladder cancer: Fallacy or opportunity?","volume":"32","author":"Pallauf","year":"2022","journal-title":"Curr. Opin. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1080\/2090598X.2020.1772031","article-title":"Active surveillance for recurrent low-grade non-muscle-invasive bladder cancer: Can we take any advantage from the COVID-19 crisis?","volume":"18","author":"Hurle","year":"2020","journal-title":"Arab. J. Urol."},{"key":"ref_15","first-page":"133","article-title":"Optimization biomarkers in the surveillance of non muscle invasive bladder cancer","volume":"75","author":"Lozano","year":"2022","journal-title":"Arch Esp. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"735868","DOI":"10.3389\/fsurg.2021.735868","article-title":"Biomarkers in Bladder Cancer Surveillance","volume":"8","author":"Sugeeta","year":"2021","journal-title":"Front. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Harsanyi, S., Novakova, Z.V., Bevizova, K., Danisovic, L., and Ziaran, S. (2022). Biomarkers of Bladder Cancer: Cell-Free DNA, Epigenetic Modifications and Non-Coding RNAs. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232113206"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/JU.0000000000003846","article-title":"Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA\/SUO Guideline: 2024 Amendment","volume":"211","author":"Holzbeierlein","year":"2024","journal-title":"J. Urol."},{"key":"ref_20","unstructured":"EAU Guidelines (2023). Edition presented at the EAU Annual Congress Milan 2023, EAU Guidelines Office."},{"key":"ref_21","first-page":"686","article-title":"Feasibility study of screening for bladder cancer with urinary molecular markers (the BLU-P project)","volume":"28","author":"Roobol","year":"2010","journal-title":"Urol. Oncol. Semin. Orig. Investig."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1111\/bju.15418","article-title":"Longitudinal follow-up and performance validation of an mRNA-based urine test (Xpert Bladder Cancer Monitor) for surveillance in patients with non-muscle-invasive bladder cancer","volume":"128","author":"Cowan","year":"2021","journal-title":"BJU Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.purol.2022.08.006","article-title":"French AFU Cancer Committee Guidelines\u2014Update 2022-2024: Non-muscle-invasive bladder cancer (NMIBC)","volume":"32","author":"Neuzillet","year":"2022","journal-title":"Progr\u00e8s En Urol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1148\/radiology.190.3.8115615","article-title":"Prevalence of ventriculomegaly in association with myelomeningocele: Correlation with gestational age and severity of posterior fossa deformity","volume":"190","author":"Babcook","year":"1994","journal-title":"Radiology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.eururo.2005.12.029","article-title":"Watchful Waiting Policy in Recurrent Ta G1 Bladder Tumors","volume":"49","author":"Gofrit","year":"2006","journal-title":"Eur. Urol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.juro.2007.08.171","article-title":"Conservative Management of Low Risk Superficial Bladder Tumors","volume":"179","author":"Pruthi","year":"2008","journal-title":"J. Urol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1016\/j.urology.2008.12.061","article-title":"Safety of Active Surveillance Program for Recurrent Nonmuscle-invasive Bladder Carcinoma","volume":"73","author":"Alvarez","year":"2009","journal-title":"Urology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1111\/bju.13536","article-title":"Active surveillance for low-risk non-muscle-invasive bladder cancer: Mid-term results from the Bladder cancer Active Surveillance project","volume":"118","author":"Hurle","year":"2016","journal-title":"BJU Int."},{"key":"ref_29","first-page":"165.e19","article-title":"Long-term oncological outcomes of an active surveillance program in recurrent low grade Ta bladder cancer","volume":"34","author":"Llorente","year":"2016","journal-title":"Urol. Oncol. Semin. Orig. Investig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"840","DOI":"10.4103\/jfmpc.jfmpc_186_17","article-title":"The role of ultrasound in diagnosis and evaluation of bladder tumors","volume":"6","author":"Gharibvand","year":"2017","journal-title":"J. Family Med. Prim. Care."},{"key":"ref_31","first-page":"114","article-title":"Accuracy of modern ultrasonographic techniques in the follow up of patients with superficial bladder carcinoma","volume":"13","author":"Stamatiou","year":"2011","journal-title":"Med. Ultrason."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1111\/j.1464-410X.2011.10642.x","article-title":"Future Prospects for Bladder Cancer Biomarkers","volume":"108","author":"Mukhtar","year":"2011","journal-title":"BJU Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"922","DOI":"10.7326\/M15-0997","article-title":"Urinary Biomarkers for Diagnosis of Bladder Cancer","volume":"163","author":"Chou","year":"2015","journal-title":"Ann. Intern Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e183","DOI":"10.1002\/ctd2.183","article-title":"Recent development of urinary biomarkers for bladder cancer diagnosis and monitoring","volume":"3","author":"Zeng","year":"2023","journal-title":"Clin. Transl. Discov."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1114203","DOI":"10.3389\/fonc.2023.1114203","article-title":"Identifying novel biomarkers associated with bladder cancer treatment outcomes","volume":"13","author":"Castaneda","year":"2023","journal-title":"Front. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1002\/ijc.34265","article-title":"Quantitative proteomics identifies TUBB6 as a biomarker of muscle-invasion and poor prognosis in bladder cancer","volume":"152","author":"Kim","year":"2023","journal-title":"Int. J. Cancer."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1158\/1078-0432.CCR-13-2637","article-title":"A Panel of Three Markers Hyper- and Hypomethylated in Urine Sediments Accurately Predicts Bladder Cancer Recurrence","volume":"20","author":"Su","year":"2014","journal-title":"Clin. Cancer Res."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Roperch, J.-P., Grandchamp, B., Desgrandchamps, F., Mongiat-Artus, P., Ravery, V., Ouzaid, I., Roupret, M., Phe, V., Ciofu, C., and Tubach, F. (2016). Promoter hypermethylation of HS3ST2, SEPTIN9 and SLIT2 combined with FGFR3 mutations as a sensitive\/specific urinary assay for diagnosis and surveillance in patients with low or high-risk non-muscle-invasive bladder cancer. BMC Cancer, 16.","DOI":"10.1186\/s12885-016-2748-5"},{"key":"ref_39","first-page":"77.e9","article-title":"Prospective Validation of Clinical Usefulness of a Novel mRNA-based Urine Test (Xpert\u00ae Bladder Cancer Monitor) for surveillance in Non Muscle Invasive Bladder Cancer","volume":"39","author":"Elsawy","year":"2021","journal-title":"Urol. Oncol. Semin. Orig. Investig."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.eururo.2016.01.007","article-title":"Genomic Alterations in Liquid Biopsies from Patients with Bladder Cancer","volume":"70","author":"Nordentoft","year":"2016","journal-title":"Eur. Urol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e704","DOI":"10.1016\/j.clgc.2019.04.001","article-title":"Urinary Cell-Free DNA IQGAP3\/BMP4 Ratio as a Prognostic Marker for Non\u2013Muscle-Invasive Bladder Cancer","volume":"17","author":"Xu","year":"2019","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4149\/neo_2018_181214N970","article-title":"Identification of urinary hsa_circ_0137439 as a potential biomarker and tumor regulator of bladder cancer","volume":"67","author":"Song","year":"2020","journal-title":"Neoplasma"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"4644","DOI":"10.12659\/MSM.901610","article-title":"Expression of N-Myc Downstream-Regulated Gene 2 in Bladder Cancer and Its Potential Utility as a Urinary Diagnostic Biomarker","volume":"23","author":"Zhang","year":"2017","journal-title":"Med. Sci. Monit."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.1111\/jcmm.13578","article-title":"Cell-free lncRNA expression signatures in urine serve as novel non-invasive biomarkers for diagnosis and recurrence prediction of bladder cancer","volume":"22","author":"Du","year":"2018","journal-title":"J. Cell Mol. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"121","DOI":"10.31557\/APJCP.2023.24.1.121","article-title":"Urine micro-RNA signature as a potential non-invasive diagnostic biomarker in bladder cancer","volume":"24","author":"Mamdouh","year":"2023","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_46","first-page":"4617","article-title":"Evaluation of microsatellite analysis in urine sediment for diagnosis of bladder cancer","volume":"60","author":"Schneider","year":"2000","journal-title":"Cancer Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1002\/cncr.21795","article-title":"Soluble Fas\u2014A promising novel urinary marker for the detection of recurrent superficial bladder cancer","volume":"106","author":"Svatek","year":"2006","journal-title":"Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"106","DOI":"10.4111\/icu.2016.57.2.106","article-title":"Value of urinary topoisomerase-IIA cell-free DNA for diagnosis of bladder cancer","volume":"57","author":"Kim","year":"2016","journal-title":"Investig. Clin. Urol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"381","DOI":"10.3233\/CBM-160261","article-title":"Urinary NID2 and TWIST1 methylation to augment conventional urine cytology for the detection of bladder cancer","volume":"18","author":"Fantony","year":"2017","journal-title":"Cancer Biomark."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s13148-018-0496-x","article-title":"Urine cell-based DNA methylation classifier for monitoring bladder cancer","volume":"10","author":"Mengual","year":"2018","journal-title":"Clin. Epigenet."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1093\/carcin\/bgy098","article-title":"MMP23B expression and protein levels in blood and urine are associated with bladder cancer","volume":"39","author":"Allione","year":"2018","journal-title":"Carcinogenesis"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Ecke, T., Wei\u00df, S., Stephan, C., Hallmann, S., Arndt, C., Barski, D., Otto, T., and Gerullis, H. (2018). UBC\u00ae Rapid Test\u2014A Urinary Point-of-Care (POC) Assay for Diagnosis of Bladder Cancer with a focus on Non-Muscle Invasive High-Grade Tumors: Results of a Multicenter-Study. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19123841"},{"key":"ref_53","first-page":"531.e1","article-title":"A urinary microRNA (miR) signature for diagnosis of bladder cancer","volume":"36","author":"Hofbauer","year":"2018","journal-title":"Urol. Oncol. Semin. Orig. Investig."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"755","DOI":"10.3389\/fonc.2020.00755","article-title":"Clinical Significance of Hotspot Mutation Analysis of Urinary Cell-Free DNA in Urothelial Bladder Cancer","volume":"10","author":"Hayashi","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"6278","DOI":"10.1172\/JCI139597","article-title":"Urine DNA methylation assay enables early detection and recurrence monitoring for bladder cancer","volume":"130","author":"Chen","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40169-020-0257-2","article-title":"Detection of bladder cancer using urinary cell-free DNA and cellular DNA","volume":"9","author":"Ou","year":"2020","journal-title":"Clin. Transl. Med."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Deng, L., Chao, H., Deng, H., Yu, Z., Zhao, R., Huang, L., Gong, Y., Zhu, Y., Wang, Q., and Li, F. (2022). A novel and sensitive DNA methylation marker for the urine-based liquid biopsies to detect bladder cancer. BMC Cancer, 22.","DOI":"10.1186\/s12885-022-09616-y"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13148-022-01240-8","article-title":"Bladder cancer detection in urine using DNA methylation markers: A technical and prospective preclinical validation","volume":"14","author":"Hentschel","year":"2022","journal-title":"Clin. Epigenet."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/CCO.0000000000000278","article-title":"Natural biology and management of nonmuscle invasive bladder cancer","volume":"28","author":"Scarpato","year":"2016","journal-title":"Curr. Opin. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.eururo.2011.05.053","article-title":"Urine Markers for Detection and Surveillance of Non\u2013Muscle-Invasive Bladder Cancer","volume":"60","author":"Tilki","year":"2011","journal-title":"Eur. Urol."},{"key":"ref_61","first-page":"1104","article-title":"Urine protein biomarkers for the detection, surveillance, and treatment response prediction of bladder cancer","volume":"9","author":"Chakraborty","year":"2019","journal-title":"Am. J. Cancer Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"6554","DOI":"10.21037\/tcr-20-1990","article-title":"Review of non-invasive urinary biomarkers in bladder cancer","volume":"9","author":"Lee","year":"2020","journal-title":"Transl. Cancer Res."},{"key":"ref_63","unstructured":"Vanderbilt University Medical Center (2023, December 10). Observation Versus Immediate Surgery of Low Risk Bladder Cancer (NCT02700724), Available online: https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT02700724."},{"key":"ref_64","unstructured":"The University of Texas Health Science Center at San Antonio (2023, December 10). Surveillance for Low and Low-Intermediate Risk Non-Muscle Invasive Bladder Cancer: A Pilot Study (NCT02298998), Available online: https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT02298998."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3233\/BLC-201535","article-title":"A Randomized Feasibility Trial Comparing Surveillance Regimens for Patients with Low and Low-Intermediate Risk Non-Muscle Invasive Bladder Cancer","volume":"7","author":"Reyes","year":"2021","journal-title":"Bladder Cancer"},{"key":"ref_66","unstructured":"Vall Hebron Insitut Recerca (2023, December 10). Active Surveillance vs in Office Fulguration for Low Grade Bladder Cancer Tumors (NCT05148728), Available online: https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT05148728."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Bilim, V., Kuroki, H., Shirono, Y., Murata, M., Hiruma, K., and Tomita, Y. (2022). Advanced Bladder Cancer: Changing the Treatment Landscape. J. Pers. Med., 12.","DOI":"10.3390\/jpm12101745"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Karimi, A., Shobeiri, P., Azadnajafabad, S., Masinaei, M., Rezaei, N., Ghanbari, A., Rezaei, N., Rouhifard, M., Shahin, S., and Rashidi, M. (2022). A global, regional, and national survey on burden and Quality of Care Index (QCI) of bladder cancer: The global burden of disease study 1990\u20132019. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0275574"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Fujii, T., Uchiyama, T., Takeda, M., and Shimada, K. (2022). Diagnostic Strategies for Urologic Cancer Using Expression Analysis of Various Oncogenic Surveillance Molecules\u2014From Non-Coding Small RNAs to Cancer-Specific Proteins. Appl. Sci., 12.","DOI":"10.3390\/app12157390"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2809","DOI":"10.21037\/tau-20-1370","article-title":"Active surveillance for prostate cancer","volume":"10","author":"Shill","year":"2021","journal-title":"Transl. Androl. Urol."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/31\/4\/163\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:27:03Z","timestamp":1760106423000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/31\/4\/163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,12]]},"references-count":70,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["curroncol31040163"],"URL":"https:\/\/doi.org\/10.3390\/curroncol31040163","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,12]]}}}