Tabayoyong William, Li Roger, Gao Jianjun, Kamat Ashish
Urology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, TX 77030, USA.
Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1374, Houston, TX 77030, USA.
Urol Clin North Am. 2018 May;45(2):155-167. doi: 10.1016/j.ucl.2017.12.002. Epub 2018 Feb 21.
Radical cystectomy with bilateral pelvic lymph node dissection is the standard of care for patients with clinically localized muscle-invasive bladder cancer. Survival after radical cystectomy is associated with final pathologic staging. Survival decreases with increasing pT stage because of the presence of occult micrometastases, indicating the need for systemic chemotherapy. Systemic chemotherapy is delivered as either neoadjuvant therapy preoperatively, or as adjuvant therapy postoperatively. This article reviews the evidence for neoadjuvant and adjuvant chemotherapy for the treatment of muscle-invasive bladder and upper tract urothelial cancer and offers recommendations based on these data and recently updated clinical guidelines.
根治性膀胱切除术联合双侧盆腔淋巴结清扫术是临床局限性肌层浸润性膀胱癌患者的标准治疗方法。根治性膀胱切除术后的生存率与最终病理分期相关。由于存在隐匿性微转移，随着pT分期增加，生存率下降，这表明需要进行全身化疗。全身化疗可作为术前新辅助治疗或术后辅助治疗。本文综述了新辅助和辅助化疗治疗肌层浸润性膀胱癌和上尿路尿路上皮癌的证据，并根据这些数据和最近更新的临床指南提供建议。
