低级别 (LG) 尿路上皮局限性（Ta 期）非肌层浸润性膀胱癌 (NMIBC) 的治疗提出了独特的治疗挑战。经尿道膀胱肿瘤切除术（TURBT）是标准治疗方法，但由于肿瘤复发率高，经常需要重复进行。这给患者和医疗保健基础设施带来了相当大的压力，凸显了对替代管理方法的需求。在此，IBCG（国际膀胱癌小组）进行了一项综述，以探索去强化治疗策略对复发性 LG Ta NMIBC 的有效性和安全性。我们对 PubMed/MEDLINE 和 Cochrane CENTRAL 数据库中的相关文献进行了合作综述。我们的重点是高质量的证据，包括随机对照试验、系统评价和荟萃分析。我们还回顾了著名泌尿外科协会发布的指南。主动监测、化疗和办公室电灼是复发性 LG Ta NMIBC 的有效治疗选择。与 TURBT 相比，这些去强化治疗方法具有多个优势：并发症发生率较低、发病率较低、医疗保健成本较低以及患者的生活质量较高。重要的是，这些益处是在不损害肿瘤学安全性的情况下实现的。我们的综述表明，针对复发性 LG Ta NMIBC 的强度较低的治疗策略既可行又有价值。 IBCG 建议对精心挑选的患者使用这些方法，以帮助降低医疗保健成本并提高患者的生活质量。我们回顾了低度非侵袭性膀胱癌的微创治疗方案的研究，包括主动监测、化学消融和热疗治疗。最近的结果证实，这些强度较低的治疗方案可以减轻患者的治疗负担和费用，并保持他们的生活质量，而不会对癌症控制结果产生负面影响。版权所有 © 2024 欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。

Management of low-grade (LG) urothelium-confined (Ta stage) non-muscle-invasive bladder cancer (NMIBC) poses a distinct therapeutic challenge. Transurethral resection of bladder tumor (TURBT), the standard treatment, frequently has to be repeated because of high tumor recurrence rates. This places a considerable strain on both patients and health care infrastructure, underscoring the need for alternative management approaches. Herein, the IBCG (International Bladder Cancer Group), conducted a review to explore the efficacy and safety of deintensified treatment strategies for recurrent LG Ta NMIBC.We conducted a collaborative review of relevant literature in the PubMed/MEDLINE and Cochrane CENTRAL databases. Our focus was on high-quality evidence, including randomized controlled trials, systematic reviews, and meta-analyses. We also reviewed guidelines published by prominent urological associations.Active surveillance, chemoablation, and office fulguration are valid treatment options for recurrent LG Ta NMIBC. These deintensified approaches offer several advantages over TURBT: lower complication rates, less morbidity, lower health care costs, and better quality of life for patients. Importantly, these benefits are achieved without compromising oncological safety.Our review demonstrates that less intensive treatment strategies for recurrent LG Ta NMIBC are both feasible and valuable. The IBCG recommends use of these approaches for carefully selected patients to help lower health care costs and enhance patients' quality of life.We reviewed studies on less invasive management options for low-grade noninvasive bladder cancer, including active surveillance, chemical ablation, and heat treatment. Recent results confirm that these less intense treatment options can reduce the treatment burden and costs for patients and preserve their quality of life without negatively affecting cancer control outcomes.Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.