Bladder Cancer


1. In 100 male patients visiting the Outpatient Clinic with LUTS and OAB:

Α. 1% are likely to develop bladder cancer

Β. 60% are likely to develop benign prostatic obstruction (BPO) 

C.22% are likely to develop benign prostatic obstruction (BPO)

D. A & B are correct

E. A & C are correct


2. How many patients with bladder cancer undergoing secondary re-staging transurethral resection (re-TUR), will be substaged after the re-TUR?

Α. 5%

Β. 13%  

C. 25%

D. 40%


3. Which of the following factors plays the least role for survival in muscle-invasive bladder cancer?

Α. Age 

Β. Lymphnode metastases

C. The pathoanatomical stage of the disease

D. The ratio infiltrated : removed lymphnodes


4. The best time period for assessing mortality and complications after radical cystectomy is:

Α. 30 days after radical cystectomy

Β. 60 days after radical cystectomy

C. 90 days after radical cystectomy

D. throughout the patient's hospital stay


5. Which of the following complications occurs more often following cystectomy?

Α. Haemorrhage

Β. Urinary tract infection (UTI)

C. Paralytic ileus 

D. Surgical wound dehiscence


6. Which of the following is not an exclusion criterion from a bladder-preservation protocol, in a patient with muscle-invasive cancer?

Α. Age>75 

Β. Hydronephrosis

C. Multifocal disease

D. CIS (carcinoma in situ)


7. Candidates for partial cystecomy after preoperative chemotherapy ARE NOT the patients with:

Α. CIS (carcinoma in situ)

Β. good bladder capacity

C. solitary tumor

D. full response to chemotherapy


8. Which of the following statements about preoperative chemotherapy in bladder cancer is true?

Α. Response is the most important prognostic factor.

Β. Preoperative chemotherapy is more effective than adjuvant chemotherapy.

C. Preoperative chemotherapy can be used in patients with lymphnode or visceral disease.

D. Preoperative chemotherapy should be used in all patients.


9.  Tri-modality therapy for bladder preservation includes:

Α. Radiotherapy - Chemotherapy - Cystectomy

Β. Chemotherapy – TUR  Radiotherapy

Γ. TUR – Radiotherapy  – Chemotherapy 

Δ. Chemotherapy - Cystectomy - Radiotherapy


10. Following Tri-modality therapy, the bladder is preserved by:

Α. 20%

Β. 50%

Γ. 5%

Δ. 80%


11. Restaging TUR (re-TUR) is recommended:

Α. when no muscle layer has been obtained 

Β. when there is no residual tumor

C. in every T1G3 patient

D. in all the above cases


12. A secondary re-staging TUR inT1G3:

Α. reduces the relapse rate

Β. improves response to the adjuvant intravesical BCG therapy

C. Α & Β

D. has no benefit


13.The most effective adjuvant intravesical BCG therapy in patients with T1G3 tumor ........

Α. starts on the 3rd postoperative day, with only one single 12-week  continuous infusion therapeutic cycle

Β. consists of only one single 6-week continuous infusion therapeutic cycle

C. consists of one single 6-week infusion therapeutic cycle, followed by a maintenance scheme of one infusion/time during the follow-up period

D.consists of an initial 6-week infusion therapeutic cycle, followed by  a maintenance scheme of three weekly infusions/time during follow-up 


14. When can immediate cystectomy be recommended  In T1G3 patients?

Α. In every case of such a tumor

Β. When there are 3 major risk factors

C. When the tumor is localized on the dome of the bladder

D. Never


15. The use of photodynamic diagnosis in muscle-invasive bladder cancer reduces:

Α.  the progression rate of the disease

Β.  the relapse rate ≥20%

C. the relapse rate < 10%

D.  none of the above


16. How many EORTC risk factors are needed in order to classify patients with non-muscle invasive (Ta, T1) bladder tumor as low-moderate-high risk for relapse or progression of the disease?

Α. 4

Β. 5

C. 6

D. 7


17. Which of the following statements is FALSE?

Α. Immediate postoperative intravesical infusion of cytotoxic agents benefits all patients.

Β.  Mitomycin‐C causes fewer complications than Farmorubicin when infused immediately postoperatively. 

C. The small extraperitoneal bladder rupture is not a contraindication for intravesical infusion after 24 hours.

 D. Α & C

Ε. All the above


18. Which of the following statements is FALSE?

Α. A second BCG cycle in a Τ1G3 tumor does not offer any benefit.

Β. A third BCG cycle in a  Τ1G3 tumor is more effective than the second cycle.

C. A second BCG cycle in a Τ1G3 tumor is a good alternative option to cystectomy at relapse Τα/cis

D. A second BCG cycle in a Τ1G3 tumor is a good alternative option to cystectomy at relapse Τ1G3.


19. Which of the following statements is FALSE?

Conservative treatment for a Τ1G3 tumor is a bad idea:

Α. in a patient with the first Τ1G3 relapse within 3-6 months

Β. in a patient with residual tumor Τ1 at re‐TUR

C. in a young patient with a tumor >3cm in size

D.  in all the above cases


20. Which of the following statements is TRUE?

Α.    Τ1G3 tumors are rare.

Β.   Τ1G3 tumors have a relapse rate of up to 80%. 

C.   Τ1G3 tumors have a relapse rate of 0%.

D.  Τ1G3 tumors  have a mortality rate of  0%.


21. Which of the below play/s a role in bladder tumor staging?

Α. The technique of transurethral resection with muscular layer in the specimen

Β. The presence of pericystic fat in the specimen

C. Cauterization of the base of the tumor

D. All the above


22. Re-staging TURB (re –TURB):

A. is performed 1 week after the first transurethral resection.

Β. does not offer more diagnostic information.

C. reduces relapse rate.

D. is always performed in combination with intravesical administration of Gemcitabine.


23. The first laparoscopic cystectomy was performed in:

Α. 1991

Β. 1992

C. 2000

D. 2001


24. Which of the following is TRUE with regard to the value of intravesical infusion of cytotoxic agents immediately after the transurethral resection (TUR) of a non-invasive tumor ?

A. It reduces the relative relapse risk by 40%.

B. It is beneficial both in solitary and multiple tumors.

C. The greatest benefit occurs when the infusion takes place within 24 hours after TUR.

D. There are no differences between drugs, with regard to efficacy. 

E. All the above


25. Which of the following answers is FALSE?

 The use of stapling devices in cystectomy seems to: 

A. significantly reduce blood loss in the hands of experienced surgeons

B. significantly reduce the duration of cystectomy in the hands of experienced surgeons

C. significantly help non-experienced Urologists by limiting blood loss during cystectomy

D. helps non-experienced Urologists by reducing the time needed for  bladder removal


26. How likely is it for a Τ1G3 bladder tumor that has relapsed within the first trimester after intravesical BCG infusions to invade the muscular wall?

A. < 10%

B. 20%

C. 30-50%

D.  >80%


27. The best treatment for bladder adenocarcinoma is:

A. Radiotherapy

B. Cystectomy

C. Chemotherapy

D. TUR + intravesical BCG infusions


Correct answers


1 Ε

9 C

17 D

25 Β

2 Β

10 Β

18 C

26 D

3 Α

11 D

19 D

27 Β

4 C

12 C

20 Β



13 D

21 Α


6 Α

14 Β

22 C


7 Α

15 Β

23 Β


16 C

24 Ε