Neuzillet Y, Comperat E, Rouprêt M, Larre S, Roy C, Quintens H, Houede N, Pignot G, Wallerand H, Soulie M, Pfister C
Service d'urologie, hôpital Foch, université de Versailles, 40, rue Worth, Saint-Quentin-en-Yvelines, 92150 Suresnes, France.
Prog Urol. 2012 Jul;22(9):495-502. doi: 10.1016/j.purol.2012.03.008. Epub 2012 Apr 28.
Cancer Committee of the French Association of Urology (CCAFU) conducted a review of the epidemiology, diagnosis and treatment of intradiverticular bladder tumours (TVID) and proposed therapeutic management.
A bibliographic research in French and English using Medline(®) with the keywords "tumor", "bladder" and "diverticulum" was performed.
TVID are more frequently of stage T ≥ 3a and with non urothelial histology than classical bladder tumors. At diagnosis, the risk of underestimation of the extent and multifocality of the tumor was described. Their prognosis, that was more pejorative than conventional tumors, should impelled to limit the indications of conservative treatment. The evidence levels of analyzed publications were low, with C level according to Sackett score.
the specificities of the TVID have lead the CCAFU to propose specific therapeutic guidelines, based on poor evidence level. Ta-T1 low grade TVID can be treated by transurethral resection alone or followed by BCG therapy in cases of associated carcinoma in situ. High-grade TVID, unifocal and without associated carcinoma in situ, can be treated by diverticulectomy associated with pelvic lymphadenectomy. High grade TVID, multiple or associated with carcinoma in situ, warranted total cystectomy.
法国泌尿外科学会癌症委员会（CCAFU）对膀胱憩室内肿瘤（TVID）的流行病学、诊断和治疗进行了综述，并提出了治疗管理建议。
使用Medline®以“肿瘤”“膀胱”和“憩室”为关键词进行了英法文文献检索。
与经典膀胱肿瘤相比，TVID更常处于T≥3a期且具有非尿路上皮组织学特征。在诊断时，描述了肿瘤范围和多灶性被低估的风险。其预后比传统肿瘤更差，这应促使限制保守治疗的适应症。分析的出版物证据水平较低，根据萨克特评分属于C级。
TVID的特殊性促使CCAFU基于低证据水平提出了特定的治疗指南。Ta-T1低级别TVID可单独行经尿道切除术，若伴有原位癌则术后行卡介苗治疗。高级别、单灶且无原位癌的TVID可通过憩室切除术联合盆腔淋巴结清扫术治疗。高级别、多发或伴有原位癌的TVID需要行全膀胱切除术。
