Department of Urology, Eberhard-Karls University, Tuebingen, Germany.
Curr Opin Urol. 2010 Sep;20(5):388-92. doi: 10.1097/MOU.0b013e32833cc9f4.
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.
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.
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.
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。
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。
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。
