Caremel Romain, Pfister Christian
Service d'urologie, hôpital Charles Nicolle, 76031 Rouen.
Rev Prat. 2007 Mar 31;57(6):621-7.
By definition, superficial bladder tumours do not invade the bladder muscle. The two main risk factors are smoking and industrial carcinogens. Gross hematuria is the most common presenting sign of bladder tumour; its finding should always prompt a cystoscopy of the lower urinary tract. The finding of a bladder tumour always requires assessment of the upper urinary tract. Endoscopic resection, performed under locoregional or general anaesthesia, is the first step in treating superficial bladder tumours. It should be complete and as deep as possible (muscle). Additional treatment with intravesical instillations may be necessary according to the at-risk group defined by the Cancer Committee of the French Urological Association. Intravesical instillations essentially consist of intravesical chemotherapy (mitomycin C) and intravesical immunotherapy (BCG). They aim at reducing the risk of tumour recurrence, as well as the risk of progression to bladder muscle invasion.
根据定义,浅表性膀胱肿瘤不侵犯膀胱肌肉。两个主要危险因素是吸烟和工业致癌物。肉眼血尿是膀胱肿瘤最常见的症状;发现肉眼血尿应始终促使对下尿路进行膀胱镜检查。发现膀胱肿瘤总是需要对上尿路进行评估。在局部或全身麻醉下进行的内镜切除术是治疗浅表性膀胱肿瘤的第一步。切除应完整且尽可能深(至肌肉层)。根据法国泌尿外科学会癌症委员会定义的高危组,可能需要进行膀胱内灌注的额外治疗。膀胱内灌注主要包括膀胱内化疗(丝裂霉素C)和膀胱内免疫治疗(卡介苗)。它们旨在降低肿瘤复发风险以及进展为膀胱肌肉浸润的风险。