<p><strong> </strong><strong>In low-risk patients, clinicians should not administer induction intravesical therapy. (<em>Moderate Recommendation; Evidence Level: Grade C</em>)</strong></p>
Discussion
Discussion
<p>Patients with low-risk NMIBC have a risk of recurrence of approximately 30-40% at 5 years.<sup>37</sup> As noted previously, a single postoperative dose of intravesical chemotherapy has been shown in multiple studies and meta-analyses to decrease the risk of recurrence, with a number needed to treat of approximately 8.5.<sup>189</sup> Subsequent studies have found that the patients most likely to benefit from a single postoperative dose are those with low-risk NMIBC.<sup>189</sup> A number of trials have examined the addition of various combinations of intravesical chemotherapy following the single postoperative dose with a goal of further decreasing the risk of recurrence. Trials of additional mitomycin C<sup>195</sup> and epirubicin<sup>196-198</sup> have demonstrated no benefit of additional chemotherapy courses compared to a single postoperative dose, and in most cases have demonstrated an increased risk of side effects.</p>