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低级别非浸润性膀胱癌的随访负担能否通过光动力诊断、围手术期灌注、影像学和尿液标志物来减轻?

Can the burden of follow-up in low-grade noninvasive bladder cancer be reduced by photodynamic diagnosis, perioperative instillations, imaging, and urine markers?

机构信息

Department of Urology, Eberhard-Karls University, Tuebingen, Germany.

出版信息

Curr Opin Urol. 2010 Sep;20(5):388-92. doi: 10.1097/MOU.0b013e32833cc9f4.


DOI:10.1097/MOU.0b013e32833cc9f4
PMID:20657287
Abstract

PURPOSE OF REVIEW: Reduce the burden of follow-up for patients and healthcare providers in noninvasive bladder cancer (NIBC). The evolution of intraoperative tumor detection, imaging modalities, urinary markers, and intravesical instillation regimens as a possibility to improve tumor eradication, enhance noninvasive tumor monitoring and thus to reduce costs is reviewed. RECENT FINDINGS: On the basis of current evidence, the recurrence and progression of patients with NIBC can significantly be improved by fluorescence-guided transurethral resection and perioperative chemoinstillation. Virtual cystoscopic modalities based on computed tomography or magnetic resonance imaging as well as a combination of urine biomarkers, which improve the sensitivity of conventional urine cytology, has the potential to reduce discomfort and pain associated with conventional cystoscopy. Recent meta-analyses have furthermore demonstrated that risk-adapted instillation regimens for immediate, induction and maintenance therapy using immuno-instillation and chemoinstillation therapy improve significantly recurrence-free and progression-free survival rates. SUMMARY: Emerging technologies in the field of tumor visualization in combination with urinary markers and effective instillation regimens can significantly reduce the risk of recurrence and progression in the long-term whilst providing less patient discomfort and simplifying the follow-up in patients of NIBC.

摘要

目的综述:减少非浸润性膀胱癌(NIBC)患者和医疗保健提供者的随访负担。本文综述了术中肿瘤检测、成像方式、尿液标志物和膀胱内灌注方案的演变,这些方法有可能提高肿瘤清除率,增强非侵入性肿瘤监测,从而降低成本。

最新发现:基于目前的证据,荧光引导经尿道切除术和围手术期化疗灌注可显著改善 NIBC 患者的复发和进展情况。基于计算机断层扫描或磁共振成像的虚拟膀胱镜检查方式以及结合尿液生物标志物,提高了常规尿液细胞学的敏感性,有可能减轻与常规膀胱镜检查相关的不适和疼痛。最近的荟萃分析还表明,使用免疫灌注和化疗灌注进行即刻、诱导和维持治疗的风险适应灌注方案,可显著提高无复发生存率和无进展生存率。

总结:肿瘤可视化领域的新兴技术与尿液标志物和有效的灌注方案相结合,可以在长期内显著降低复发和进展的风险,同时为患者提供较少的不适,并简化 NIBC 患者的随访。

相似文献

[1]
Can the burden of follow-up in low-grade noninvasive bladder cancer be reduced by photodynamic diagnosis, perioperative instillations, imaging, and urine markers?

Curr Opin Urol. 2010-9

[2]
Photodynamic diagnostics and noninvasive bladder cancer: is it cost-effective in long-term application? A Germany-based cost analysis.

Eur Urol. 2007-7

[3]
[Urinary BTA-TRAK in the follow-up of superficial transitional-cell bladder carcinoma].

Arch Esp Urol. 2002

[4]
uCyt+ test: alternative to cystoscopy for less-invasive follow-up of patients with low risk of urothelial carcinoma.

Urology. 2006-5

[5]
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Eur Urol. 2014-7-4

[6]
Recurrence, progression and success in stage Ta grade 3 bladder tumors treated with low dose bacillus Calmette-Guerin instillations.

J Urol. 2000-1

[7]
Hexaminolevulinate-guided fluorescence cystoscopy in the diagnosis and follow-up of patients with non-muscle-invasive bladder cancer: review of the evidence and recommendations.

Eur Urol. 2010-1-22

[8]
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Eur Urol. 2007-5

[9]
Perioperative instillation therapy in superficial bladder cancer: is it effective regarding outcome and costs?

Curr Opin Urol. 2009-9

[10]
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Anticancer Res. 2002

引用本文的文献

[1]
Improved Non-Invasive Diagnosis of Bladder Cancer with an Electronic Nose: A Large Pilot Study.

J Clin Med. 2021-10-27

[2]
The prognostic role of pre-cystectomy hemoglobin levels in patients with invasive bladder cancer.

World J Urol. 2016-6

[3]
[Non-muscle-invasive high-grade bladder cancer].

Urologe A. 2015-4

[4]
[Urine cytology - update 2013. A systematic review of recent literature].

Urologe A. 2013-9

[5]
A pilot study combining a GC-sensor device with a statistical model for the identification of bladder cancer from urine headspace.

PLoS One. 2013-7-8

[6]
Bladder cancer diagnosis and identification of clinically significant disease by combined urinary detection of Mcm5 and nuclear matrix protein 22.

PLoS One. 2012-7-9

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