Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
Urology. 2021 Jan;147:7-13. doi: 10.1016/j.urology.2020.05.023. Epub 2020 May 20.
The heterogenous nature of high-risk nonmuscle invasive bladder cancer encompasses a wide range of tumor biologies with varying recurrence and progression risks. Radical cystectomy provides excellent oncologic outcomes but is often underutilized. Timing for these patients is critical, however, to its effectiveness. Certain unfavorable tumor characteristics predict worse outcomes and may help select the most appropriate patients for more aggressive initial therapy. This manuscript aims to outline factors that predict worse outcomes in high-risk nonmuscle invasive bladder cancer and proposes which patients may benefit most from a timely radical cystectomy.
高危非肌肉浸润性膀胱癌具有异质性，涵盖了广泛的肿瘤生物学特征，其复发和进展风险也各不相同。根治性膀胱切除术可提供良好的肿瘤学结果，但往往未被充分利用。然而，对于这些患者来说，手术时机至关重要，因为这会影响其有效性。某些不利的肿瘤特征预示着更差的预后，并可能有助于选择最合适的患者进行更积极的初始治疗。本文旨在概述预测高危非肌肉浸润性膀胱癌不良预后的因素，并提出哪些患者可能从及时的根治性膀胱切除术获益最多。
