Department of Urology, Skåne University Hospital, Lund, Sweden; Department of Translational Medicine, Lund University, Malmö, Sweden.
Department of Urology, Skåne University Hospital, Lund, Sweden; Department of Translational Medicine, Lund University, Malmö, Sweden.
Eur Urol. 2017 Jun;71(6):851-853. doi: 10.1016/j.eururo.2016.10.010. Epub 2016 Oct 20.
Radical cystectomy with neoadjuvant chemotherapy is the gold standard for treating muscle-invasive bladder cancer. Women subjected to radical cystectomy are frequently postmenopausal, and the median age for bladder cancer diagnosis in women in Sweden is currently 73 yr (Swedish National Bladder Cancer Register). Traditionally, most women treated with radical cystectomy have undergone simultaneous bilateral oophorectomy and hysterosalpingectomy to diminish the risk of later ovarian disease and ovarian bladder cancer recurrence, but also the belief that there is no impact on health or health-related quality of life associated with oophorectomy and the fact that it might be easier surgery to take the ovarian pedicles, rather than sparing the ovaries. However, pelvic organ preservation is considered in some younger women to diminish postoperative functional impairment. Based on recent literature in several areas related to oophorectomy, we question the rationale and arguments for performing oophorectomy in women in conjunction with radical cystectomy for bladder cancer.
根治性膀胱切除术联合新辅助化疗是治疗肌层浸润性膀胱癌的金标准。接受根治性膀胱切除术的女性通常处于绝经后状态，目前瑞典女性膀胱癌诊断的中位年龄为 73 岁（瑞典国家膀胱癌登记处）。传统上，大多数接受根治性膀胱切除术的女性同时进行双侧卵巢切除术和子宫切除术，以降低以后发生卵巢疾病和卵巢膀胱癌复发的风险，但也有观点认为卵巢切除术不会影响健康或与健康相关的生活质量，而且切除卵巢蒂比保留卵巢更容易手术。然而，在一些年轻女性中，为了减少术后功能障碍，考虑保留盆腔器官。基于最近在与卵巢切除术相关的几个领域的文献，我们对在因膀胱癌接受根治性膀胱切除术的女性中进行卵巢切除术的理由和论点提出了质疑。
