Department of Urology, Medical University of Vienna, Vienna, Austria.
University of Studies of Torino, Torino, Italy.
Eur Urol Oncol. 2021 Aug;4(4):663-669. doi: 10.1016/j.euo.2019.07.006. Epub 2019 Sep 1.
A relatively young (64-yr old) long-term heavy smoker but otherwise very healthy man is diagnosed with a primary unifocal left-side tumour (urothelial, T1 high grade), but no lymphovascular invasion and no variant histology. We discuss whether treatment with intravesical bacillus Calmette-Guérin vaccine will be sufficient or early radical cystectomy is at least equally preferred regarding patient benefit, safety, and quality of life. PATIENT SUMMARY: A patient with a single high-grade T1 bladder tumour without aggressive features (eg, lymphovascular invasion or variant tumour aspects) will be adequately treated with bacillus Calmette-Guérin intravesical therapy delivered into the bladder, followed by 3 yr of maintenance. However, all decisions should be taken with the patient in a shared decision-making process, including a discussion regarding removal of the bladder.
一位相对年轻（64 岁）的长期重度吸烟者，但其他方面非常健康，被诊断出患有原发性单侧肿瘤（尿路上皮癌，高级别 T1 期），但无淋巴血管侵犯，也无异型组织学。我们讨论了膀胱内卡介苗疫苗治疗是否足够，或者早期根治性膀胱切除术在患者获益、安全性和生活质量方面是否同样优先。患者概况：患有单个高级别 T1 期膀胱肿瘤且无侵袭性特征（例如，淋巴血管侵犯或肿瘤异型性）的患者，通过将卡介苗注入膀胱进行膀胱内治疗，并进行 3 年的维持治疗，即可得到充分治疗。然而，所有决策都应在患者参与的共同决策过程中做出，包括讨论是否切除膀胱。
