Martin Jeremy W, Carballido Estrella M, Ahmed Ahmed, Farhan Bilal, Dutta Rahul, Smith Cody, Youssef Ramy F
Department of Urology, University of California - Irvine, Orange, CA, USA.
Division of Hematology and Medical Oncology, Mayo Clinic Cancer Center, Scottsdale, AZ, USA.
Arab J Urol. 2016 Aug 1;14(3):183-91. doi: 10.1016/j.aju.2016.07.001. eCollection 2016 Sep.
To highlight the current understanding of the epidemiology, clinicopathological characteristics, and management of squamous cell carcinoma (SCC) of the bladder, as it accounts for 2-5% of bladder tumours, with a focus on non-bilharzial-associated SCC (NB-SCC). The standard treatment for bladder SCC remains radical cystectomy (RC). We present an updated clinical profile of bladder SCC and a review of NB-SCC therapeutic approaches, including RC, neoadjuvant and adjuvant treatments, radiotherapy, chemotherapy, and immunotherapy.
Using search terms relating to SCC, urinary bladder, and treatment modalities, we performed a search of the PubMed and Embase databases to identify NB-SCC treatment approaches and outcomes. Peer-reviewed English language reports from 1975 to present assessing SCC management were included. Two authors independently screened and extracted the data.
Of the 806 articles screened, 10 met the pre-defined inclusion criteria. RC was performed in seven of the 10 studies. Although radiotherapy alone yielded poor outcomes, preoperative radiotherapy and RC were associated with improved survival. There is little evidence supporting the use of chemotherapy in NB-SCC, and its efficacy in relation to RC is not known.
Based on current literature, there is insufficient evidence to provide a treatment recommendation for NB-SCC. Whilst RC is the standard of care, the role of preoperative radiotherapy should be revisited and compared to RC alone. Additional studies incorporating multimodal approaches, contemporary radiation techniques, and systemic therapies are warranted. Immunotherapy as a treatment for bladder SCC has yet to be investigated.
强调目前对膀胱鳞状细胞癌（SCC）的流行病学、临床病理特征及治疗的认识，因为它占膀胱肿瘤的2%-5%，重点是非血吸虫相关性SCC（NB-SCC）。膀胱SCC的标准治疗方法仍然是根治性膀胱切除术（RC）。我们展示了膀胱SCC的最新临床概况，并综述了NB-SCC的治疗方法，包括RC、新辅助和辅助治疗、放疗、化疗及免疫治疗。
使用与SCC、膀胱及治疗方式相关的检索词，对PubMed和Embase数据库进行检索，以确定NB-SCC的治疗方法和结果。纳入1975年至今评估SCC治疗的经同行评审的英文报告。两位作者独立筛选并提取数据。
在筛选的806篇文章中，10篇符合预定义的纳入标准。10项研究中有7项进行了RC。尽管单纯放疗效果不佳，但术前放疗和RC与生存率提高相关。几乎没有证据支持在NB-SCC中使用化疗，其与RC相关的疗效尚不清楚。
基于目前的文献，没有足够的证据为NB-SCC提供治疗建议。虽然RC是标准治疗方法，但术前放疗的作用应重新审视并与单纯RC进行比较。需要开展更多纳入多模式方法、现代放疗技术及全身治疗的研究。免疫治疗作为膀胱SCC的一种治疗方法尚未得到研究。
