Asadauskiene Jolita, Aleknavicius Eduardas, Zelviene Terese Pipiriene, Jankevicius Feliksas
Institute of Oncology, Vilnius University, Vilnius, Lithuania.
Medicina (Kaunas). 2006;42(10):781-7.
Radical cystectomy is the standard of treatment for muscle-invasive transitional cell carcinoma of the bladder in European Union and in United States. During the last few decades, several clinical trials were performed with the aim to evaluate new treatment methods as an alternative to radical cystectomy for selected patient groups. According to some clinical trials, it is clear that bladder preservation is possible without compromising overall survival of these patients. Organ preservation requires a combined-modality treatment including transurethral resection of bladder tumor, radiation therapy, and systemic chemotherapy. Incorporation of chemotherapeutic agents such as gemcitabine or taxanes in bladder-sparing protocols improves the results of conservative treatment of locally advanced bladder cancer. Pretreatment selection criteria and the most important prognostic factors are macroscopically complete transurethral resection of bladder tumor, absence of hydronephrosis, and lower T stage.
根治性膀胱切除术是欧盟和美国肌肉浸润性膀胱移行细胞癌的标准治疗方法。在过去几十年中，进行了几项临床试验，目的是评估新的治疗方法，作为特定患者群体根治性膀胱切除术的替代方案。根据一些临床试验，很明显，在不影响这些患者总体生存率的情况下可以保留膀胱。器官保留需要综合治疗，包括经尿道膀胱肿瘤切除术、放射治疗和全身化疗。在保留膀胱的方案中加入吉西他滨或紫杉烷等化疗药物可改善局部晚期膀胱癌保守治疗的效果。预处理选择标准和最重要的预后因素是膀胱肿瘤经尿道宏观上完全切除、无肾积水以及较低的T分期。
