INTRODUCTION
Despite the low progression and mortality rates of non-muscle-invasive bladder cancer these cancers can demonstrate high recurrence rates and have the potential to progress to panurothelial disease.
PATIENT INFORMATION OR CLINICAL FINDINGS
A 61-year old male presented with a history of recurrent non-muscle-invasive bladder cancer. Since the initial diagnosis of low-grade Ta transitional-cell carcinoma in 2014 he had four recurrences after treatment with transurethral resection and adjuvant bacillus Calmette-Guérin and mitomycine C till 2015. Last pathology report showed high-grade pT1. In 2015 an early radical cystoprostatectomy was performed with ileal orthotopic neobladder urinary diversion, resection revealed a Ta/Tis partially low-grade but predominantly high-grade disease with negative lymph nodes. Eight months later a single lesion of 3cm in the right renal pelvis was diagnosed without evidence of lymphadenopathy or metastatic disease. He underwent a nephro-ureterectomy on the right side, final pathology showed a low-grade Ta urothelialcell carcinoma with negative section margins. In 2019 detection of local recurrence in the cranial aspect of the neobladder with involvement of both distal ureters and a metachrone lesion in the proximal left lumbal ureter. A resection of the neobladder, residual right ureter and complete left ureter and reconstruction with pyelo-ileoconduit was performed. Pathology report revealed high grade urothelialcell carcinoma from the right ureter expanding into the neobladder, with a positive section margin of the proximal left ureter. The patient developed tumor recurrences in his solitary kidney. He declines left side nefrectomy since it necessitates dialysis. Decision was made to treat him endoscopically. Since then he had 6 recurrences all treated endoscopic with biopsy and lasering. Pathology samples has always shown Ta or T1. Since december 2020 he underwent adjuvant intracavitary chemotherapy with Epirubicine but continues to develop recurrences.
DIAGNOSIS AND TREATMENT
Multiple recurrence of urothelialcell carcinoma of the upper urinary tract after extended excision of the urothelial surface. Currently nephron sparing endoscopic restrain on 3-monthly intervals with adjuvant intracavitary Epirubicine. Intracavitary chemotherapy is impeded by rapid washout.
CONCLUSION
A radical approach with extended excision in order to further decrease the urothelial surface and reduce the risk of recurrence might be necessary in some patients with non-muscle-invasive bladder cancer and upper tract urothelial carcinoma but can not prevent all recurrence.

MANAGEMENT OF RECURRENT UROTHELIAL DISEASE IN NON MUSCLE INVASIVE UROTHELIAL CANCER OF A SOLITARY KIDNEY AFTER PYELO-ILEOCONDUIT

For 2021, our focus remains: turning new data into your daily practice. The programme will consist of state-of-the-art lectures, case discussions and panel debates. Our faculty is a group of international & multidisciplinary experts.

We will take you on our journey to Ghent and beyond. Prior the congress, we send out case challenges, where you can compare your opinion with peers & experts. These cases will be part of the Global Congresses on Prostate & Bladder Cancer programme during the congress days (12 & 13 October for PROSCA and 14 & 15 October for BLADDR). After these days, you will be updated on prostate & bladder cancer management.