无法接受或拒绝膀胱切除术的浸润性膀胱癌患者的管理。
Management of invasive bladder cancer in patients who are not candidates for or decline cystectomy.
机构信息
Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
出版信息
Ther Adv Urol. 2011 Jun;3(3):107-17. doi: 10.1177/1756287211407543.
Abstract
Bladder cancer is a common malignancy seen in older adults with coexisting medical illnesses. The management of patients with muscle invasive disease includes perioperative chemotherapy and radical cystectomy; however, patients may decline surgery and older patients with comorbid conditions may not be candidates for surgery and thus alternative treatment strategies are needed. Trimodality bladder preservation protocols for muscle invasive bladder cancer have generally included only those patients who are candidates for a salvage cystectomy. In this review, we discuss the current status of bladder preservation treatment options for patients with muscle-invasive disease who are not candidates for cystectomy or who decline surgery and highlight the need for clinical trials investigating novel treatment approaches in this older patient population.
摘要
膀胱癌是一种常见的恶性肿瘤，多见于患有并存疾病的老年人。肌层浸润性疾病患者的管理包括围手术期化疗和根治性膀胱切除术；然而，患者可能会拒绝手术，而且合并症较多的老年患者可能不适合手术，因此需要替代治疗策略。肌层浸润性膀胱癌的三联膀胱保留方案通常仅包括那些适合挽救性膀胱切除术的患者。在这篇综述中，我们讨论了对于不适合接受膀胱切除术或拒绝手术的肌层浸润性疾病患者的膀胱保留治疗选择的现状，并强调了在这一年龄段患者人群中进行新的治疗方法的临床试验的必要性。
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