Nanavati Super-Specialty Hospital, S.V Road, Vile Parle West, Mumbai 400056, India; Department of Urology, University of Miami Miller School of Medicine.
Department of Urology, Member Sylvester Cancer Center, University of Miami Miller School of Medicine, University of Miami Health System, 1120 Northwest 14th Street, Suite 1560B, Miami, FL 33136, USA.
Hematol Oncol Clin North Am. 2021 Jun;35(3):543-566. doi: 10.1016/j.hoc.2021.02.005. Epub 2021 Apr 15.
The cornerstone for diagnosis and treatment of bladder and upper tract urothelial carcinoma involves surgery. Transurethral resection of bladder tumors forms the basis of further management. Radical cystectomy for invasive bladder carcinoma provides good oncologic outcomes. However, it can be a morbid procedure, and advances such as minimally invasive surgery and early recovery after surgery need to be incorporated into routine practice. Diagnostic ureteroscopy for upper tract carcinoma is needed in cases of doubt after cytology and imaging studies. Low-risk cancers can be managed with conservative endoscopic surgery without compromising oncological outcomes; however, high-risk disease necessitates radical nephroureterectomy.
膀胱和上尿路尿路上皮癌的诊断和治疗的基石是手术。经尿道膀胱肿瘤切除术是进一步治疗的基础。浸润性膀胱癌的根治性膀胱切除术可获得良好的肿瘤学结果。然而，它可能是一种病态的手术，因此需要将微创技术和术后早期康复等进展纳入常规实践。在细胞学和影像学检查后仍有疑问的情况下，需要进行诊断性输尿管镜检查以明确上尿路癌。低危癌症可以通过保守的内镜手术进行治疗，而不会影响肿瘤学结果；然而，高危疾病需要根治性肾输尿管切除术。
