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[局部晚期或寡转移性膀胱癌——原发肿瘤及转移灶局部治疗的作用]

[Locally advanced or oligometastatic bladder cancer-role of local treatment of the primary tumor and metastases].

作者信息

Rebhan Katharina, Gust Kilian M

机构信息

Universitätsklinik für Urologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

出版信息

Urologe A. 2021 Dec;60(12):1555-1560. doi: 10.1007/s00120-021-01712-4. Epub 2021 Nov 26.

Abstract

BACKGROUND

Treatment of muscle invasive bladder cancer can be challenging since treatment is associated with significant side effects and complication rates-especially in patients who often present with relevant comorbidities. In the metastatic stage, the purpose of treatment is palliation, although the oligometastatic stage takes a distinct role. At this stage, treatment of the primary tumor can play a role, if metastasis can be treated locally in addition to systemic treatment, especially the evolving drug treatment landscape could also change long holding paradigms in the near future.

OBJECTIVES

This review focuses on the influence of definitive treatment of the primary tumor in patients with oligometastatic urothelial bladder cancer.

MATERIALS AND METHODS

Based on a literature search, the aim was to summarize data and give an overview on treatment of oligo-metastatic bladder cancer with focus on treatment of the primary tumor. Presented data derived mostly from retrospective studies and meta-analyses.

CONCLUSION

Local treatment of the primary tumor in context of a multimodal therapy of lymph node metastatic or oligometastatic bladder cancer can have a positive influence on survival, quality of life and prevention of local complications in selected patients. The choice of local treatment should follow the same criteria as in non-metastatic bladder cancer.

摘要

背景

肌肉浸润性膀胱癌的治疗具有挑战性,因为治疗会带来显著的副作用和并发症发生率,尤其是对于那些常伴有相关合并症的患者。在转移阶段,治疗目的是缓解症状,尽管寡转移阶段具有独特作用。在此阶段,如果除全身治疗外还能对转移灶进行局部治疗,那么原发肿瘤的治疗就能发挥作用,特别是不断发展的药物治疗格局在不久的将来也可能改变长期以来的治疗模式。

目的

本综述聚焦于寡转移尿路上皮膀胱癌患者中原发肿瘤确定性治疗的影响。

材料与方法

基于文献检索,旨在总结数据并概述寡转移膀胱癌的治疗,重点是原发肿瘤的治疗。所呈现的数据大多来自回顾性研究和荟萃分析。

结论

在淋巴结转移或寡转移膀胱癌的多模式治疗中,原发肿瘤的局部治疗对特定患者的生存、生活质量及局部并发症预防可能产生积极影响。局部治疗的选择应遵循与非转移性膀胱癌相同的标准。

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