Garrido Siles Marga, López-Beltran Antonio, Pelechano Paula, García Vicente Ana María, Gironés Sarrió Regina, González-Haba Peña Eva, Rodríguez Antolín Alfredo, Zapatero Almudena, Arranz José Ángel, Climent Miguel Ángel
Oncology Pharmacy Department, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain.
Department of Morphology Sciences, University of Cordoba Medical School, 14004 Cordoba, Spain.
Cancers (Basel). 2022 Aug 17;14(16):3968. doi: 10.3390/cancers14163968.
Recommendations regarding transversal topics applicable to bladder cancer patients independent of tumor grade and stage were established by members of the Spanish Oncology Genitourinary Multidisciplinary Working Group (SOGUG). Liquid biopsy in urine and blood samples is useful in the surveillance of non-muscle-invasive and muscle-invasive bladder cancer, respectively. Multiparametric MRI is an accurate, faster and non-invasive staging method overcoming the understaging risk of other procedures. The combination of FDG-PET/MRI could improve diagnostic reliability, but definite criteria for imaging interpretation are still unclear. Hospital oncology pharmacists as members of tumor committees improve the safety of drug use. Additionally, safety recommendations during BCG preparation should be strictly followed. The initial evaluation of patients with bladder cancer should include a multidimensional geriatric assessment. Orthotopic neobladder reconstruction should be offered to motivated patients with full information of self-care requirements. Bladder-sparing protocols, including chemoradiation therapy and immune checkpoints inhibitors (ICIs), should be implemented in centers with well-coordinated multidisciplinary teams and offered to selected patients. The optimal strategy of treatment with ICIs should be defined from the initial diagnostic phase with indications based on scientific evidence. Centralized protocols combined with the experience of professional groups are needed for the integral care of bladder cancer patients.
西班牙泌尿生殖系统肿瘤多学科工作组（SOGUG）的成员制定了适用于膀胱癌患者的横向主题建议，这些建议与肿瘤分级和分期无关。尿液和血液样本的液体活检分别对非肌层浸润性和肌层浸润性膀胱癌的监测有用。多参数MRI是一种准确、快速且无创的分期方法，克服了其他检查分期不足的风险。FDG-PET/MRI联合使用可提高诊断可靠性，但影像学解读的明确标准仍不清晰。医院肿瘤药师作为肿瘤委员会成员可提高用药安全性。此外，卡介苗（BCG）制备过程中的安全建议应严格遵守。膀胱癌患者的初始评估应包括多维老年评估。对于有积极性的患者，应在充分告知自我护理要求的情况下提供原位新膀胱重建术。膀胱保留方案，包括放化疗和免疫检查点抑制剂（ICI），应在多学科团队协调良好的中心实施，并提供给选定的患者。ICI治疗的最佳策略应从初始诊断阶段开始确定，依据科学证据给出适应症。膀胱癌患者的综合护理需要集中式方案与专业团队经验相结合。
