Stöckle M
Urologische Klinik und Poliklinik, Johannes Gutenberg-Universität Mainz.
Urologe A. 1994 Nov;33(6):568-75.
The aim of adjuvant polychemotherapy after radical cystectomy for patients with a high risk of tumor progression is to improve cure rates or at least prolong survival. So far, three prospectively randomized and several retrospective studies analyzing the benefit of adjuvant polychemotherapy have been performed. All have revealed longer survival times after adjuvant chemotherapy. The up-dated data from our own study increasingly suggest that a significant improvement of tumor-free survival rates is also possible, which is in accordance with the retrospective studies published so far. The extension of lymph node involvement, however, seems to be the most important independent prognostic variable. Further studies are necessary to define therapy-specific risk groups and the potential therapeutic benefit in the different groups. The optimal chemotherapy combination and the optimal dosage also remain to be defined.
对于具有高肿瘤进展风险的患者，根治性膀胱切除术后辅助多药化疗的目的是提高治愈率或至少延长生存期。到目前为止，已经进行了三项分析辅助多药化疗益处的前瞻性随机研究和几项回顾性研究。所有研究均显示辅助化疗后生存期延长。我们自己研究的最新数据越来越表明，无瘤生存率也有可能显著提高，这与迄今发表的回顾性研究一致。然而，淋巴结受累范围似乎是最重要的独立预后变量。有必要进行进一步研究以确定特定治疗的风险组以及不同组中的潜在治疗益处。最佳化疗组合和最佳剂量也有待确定。
