Kamradt J, Ohlmann C-H, Stöckle M
Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Kirrbergerstrasse 1, Gebäude 6, Homburg/Saar, Germany.
Urologe A. 2011 Sep;50 Suppl 1:179-83. doi: 10.1007/s00120-011-2682-8.
Considerable progress has been made in nearly all clinical scenarios of bladder carcinoma. Nevertheless early detection of bladder carcinoma using urine markers is still difficult so that none of the available tests can be recommended as a screening test. Photodynamic diagnostics and resection has now been shown for the first time to improve recurrence-free survival of patients but this impact on survival has to be confirmed in a phase III clinical trial before being regarded as standard of care. In pT1G3 tumors early cystectomy seems to improve the prognosis compared to organ preserving strategies. The value of adjuvant chemotherapy is becoming more and more evident, as, apart from several retrospective analyses it has been shown to improve survival in a clinical phase III trial. Furthermore, molecular markers are gaining importance and in the future can be used for identifying patients who may benefit from systemic chemotherapy of bladder carcinoma.
在膀胱癌的几乎所有临床情况中都取得了相当大的进展。然而，使用尿液标志物早期检测膀胱癌仍然困难，因此目前没有任何可用的检测方法可被推荐用于筛查。光动力诊断和切除术现已首次显示可提高患者的无复发生存率，但在被视为标准治疗方法之前，这种对生存的影响必须在III期临床试验中得到证实。对于pT1G3肿瘤，与保留器官的策略相比，早期膀胱切除术似乎可改善预后。辅助化疗的价值越来越明显，因为除了多项回顾性分析外，它已在一项临床III期试验中显示可提高生存率。此外，分子标志物正变得越来越重要，未来可用于识别可能从膀胱癌全身化疗中获益的患者。
