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非肌层浸润性膀胱癌的整块切除:真的有区别吗?

En-bloc resection of non-muscle invasive bladder cancer: does it really make a difference?

作者信息

Tonin Elena, Shariat Shahrokh F, Schiavina Riccardo, Brunocilla Eugenio, D'Andrea David

机构信息

Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

出版信息

Curr Opin Urol. 2023 Mar 1;33(2):147-151. doi: 10.1097/MOU.0000000000001073. Epub 2023 Jan 9.

Abstract

PURPOSE OF REVIEW

Transurethral resection of bladder tumour (TURBT) followed by pathology investigation of the obtained specimens is the initial step in the management of urinary bladder cancer (UBC). By following the basic principles of oncological surgery, en-bloc resection of bladder tumour (ERBT) aims to overcome the limitations associated with conventional transurethral resection, and to improve the quality of pathological specimens for a better decision making. The current bulk of evidence provides controversial results regarding the superiority of one technique over the other. The aim of this article is to summarize the recent data and provide evidence on this unanswered question.

RECENT FINDINGS

Despite heterogeneous and controversial data, ERBT seems to have a better safety profile and deliver higher quality pathologic specimens. However, the recent evidence failed to support the hypothesized oncological potential benefits of ERBT in the initial surgical treatment of patients with UBC.

SUMMARY

ERBT has gained increasing interest globally in the past decade. It continues to represent a promising strategy with a variety of features intended to solve the inherent limitations of TURBT. However, the current quality of evidence does not allow solid conclusions to be drawn about its presumed superiority compared with the conventional technique.

摘要

综述目的

经尿道膀胱肿瘤切除术(TURBT)并对获取的标本进行病理检查是膀胱癌(UBC)管理的初始步骤。遵循肿瘤外科的基本原则,整块切除膀胱肿瘤(ERBT)旨在克服与传统经尿道切除术相关的局限性,并提高病理标本质量以做出更好的决策。目前大量证据对于一种技术优于另一种技术的问题给出了相互矛盾的结果。本文旨在总结近期数据并为这个未解决的问题提供证据。

近期发现

尽管数据存在异质性且有争议,但ERBT似乎具有更好的安全性并能提供更高质量的病理标本。然而,近期证据未能支持ERBT在UBC患者初始手术治疗中具有假设的肿瘤学潜在益处这一观点。

总结

在过去十年中,ERBT在全球范围内越来越受到关注。它仍然是一种有前景的策略,具有多种旨在解决TURBT固有局限性的特点。然而,目前的证据质量不允许就其与传统技术相比的假定优越性得出确凿结论。

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