Kim John, Randhawa Harkanwal, Sands David, Lambe Shahid, Puglia Marco, Serrano Pablo E, Pinthus Jehonathan H
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Division of Urology, McMaster University, Hamilton, ON, Canada.
Bladder Cancer. 2021 Aug 31;7(3):261-278. doi: 10.3233/BLC-211536. eCollection 2021.
The incidence of liver cirrhosis is increasing worldwide. Patients with cirrhosis are generally at a higher risk of harbouring hepatic and non-hepatic malignancies, including bladder cancer, likely due to the presence of related risk factors such as smoking. Cirrhosis can complicate both the operative and non-surgical management of bladder cancer. For example, cirrhotic patients undergoing abdominal surgery generally demonstrate worse postoperative outcomes, and chemotherapy in patients with cirrhosis often requires dose reduction due to its direct hepatotoxic effects and reduced hepatic clearance. Multiple other considerations in the peri-operative management for cirrhosis patients with muscle-invasive bladder cancer must be taken into account to optimize outcomes in these patients. Unfortunately, the current literature specifically related to the treatment of cirrhotic bladder cancer patients remains sparse. We aim to review the literature on treatment considerations for this patient population with respect to perioperative, surgical, and adjuvant management.
肝硬化的发病率在全球范围内呈上升趋势。肝硬化患者通常患肝脏和非肝脏恶性肿瘤的风险更高，包括膀胱癌，这可能是由于存在吸烟等相关风险因素。肝硬化会使膀胱癌的手术和非手术治疗复杂化。例如，接受腹部手术的肝硬化患者术后结果通常较差，由于其直接的肝毒性作用和肝脏清除率降低，肝硬化患者的化疗往往需要减少剂量。对于肌层浸润性膀胱癌的肝硬化患者，围手术期管理中还必须考虑多个其他因素，以优化这些患者的治疗结果。不幸的是，目前专门针对肝硬化膀胱癌患者治疗的文献仍然很少。我们旨在回顾关于该患者群体在围手术期、手术和辅助治疗管理方面的治疗考虑的文献。
