Tang Dominic H, Chang Sam S
Department of Urologic Surgery, Vanderbilt University Medical Center, MCN A-1302, Nashville, TN 37027, USA.
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Ther Adv Urol. 2015 Dec;7(6):351-64. doi: 10.1177/1756287215599694.
Management of carcinoma in situ of the bladder remains a complex and challenging endeavor due to its high rate of recurrence and progression. Although it is typically grouped with other nonmuscle invasive bladder cancers, its higher grade and aggressiveness make it a unique clinical entity. Intravesical bacillus Calmette-Guérin is the standard first-line treatment given its superiority to other agents. However, high rates of bacillus Calmette-Guérin failure highlight the need for additional therapies. Radical cystectomy has traditional been the standard second-line therapy, but additional intravesical therapies may be more appealing for non-surgical candidates and patients refusing cystectomy. The subject of this review is the treatment strategies and available therapies currently available for carcinoma in situ of the bladder. It discusses alternative intravesical treatment options for patients whose condition has failed to respond to bacillus Calmette-Guérin therapy and who are unfit or unwilling to undergo cystectomy.
由于膀胱原位癌的高复发率和进展率，其管理仍然是一项复杂且具有挑战性的工作。尽管它通常与其他非肌层浸润性膀胱癌归为一类，但其更高的分级和侵袭性使其成为一个独特的临床实体。鉴于卡介苗比其他药物更具优势，膀胱内灌注卡介苗是标准的一线治疗方法。然而，卡介苗的高失败率凸显了额外治疗的必要性。根治性膀胱切除术传统上一直是标准的二线治疗方法，但对于非手术候选者和拒绝膀胱切除术的患者，额外的膀胱内治疗可能更具吸引力。本综述的主题是目前可用于膀胱原位癌的治疗策略和可用疗法。它讨论了对于卡介苗治疗无效且不适合或不愿意接受膀胱切除术的患者的替代膀胱内治疗选择。
