vom Dorp F, Tschirdewahn S, Rübben H, Jocham D
Klinik und Poliklinik für Urologie, Kinderurologie und Urologische Onkologie, Comprehensive Cancer Center, Universitätsklinikum Essen, Hufelandstraße 55, 45122 Essen.
Urologe A. 2010 Oct;49(10):1274-6. doi: 10.1007/s00120-010-2396-3.
Patients with non-muscle-invasive transitional cell carcinoma are treated in a risk-adopted fashion. Genetically stable low-grade tumors are treated with transurethral resection followed by optional intravesical treatment to prevent tumor recurrence. In cases of high-grade tumors, transurethral resection is followed by a second resection after 4-6 weeks. For patients with carcinoma in situ or high-grade T1 carcinomas, guidelines recommend BCG treatment to prevent recurrence and progression. These recommendations are based on meta-analyses resulting in a 4% reduction of tumor progression. Results published in 2009 and 2010 critically analyze BCG treatment of high-grade bladder tumors and are the focus of this article.
非肌层浸润性移行细胞癌患者采用风险适应性治疗方式。基因稳定的低级别肿瘤采用经尿道切除术治疗，随后可选择膀胱内灌注治疗以预防肿瘤复发。对于高级别肿瘤患者，经尿道切除术后4 - 6周进行二次切除。对于原位癌或高级别T1期癌患者，指南推荐采用卡介苗（BCG）治疗以预防复发和进展。这些建议基于荟萃分析，可使肿瘤进展降低4%。2009年和2010年发表的研究结果对高级别膀胱肿瘤的卡介苗治疗进行了批判性分析，也是本文的重点。
