Ung thư bàng quang không xâm lấn và xâm lấn

Springer Science and Business Media LLC - Tập 45 - Trang 873-886 - 2006
P. J. Goebell1,2, F. vom Dorp1,2, C. Rödel3, D. Frohneberg4, J. W. Thüroff5, D. Jocham6, C. Stief7, S. Roth8, R. Knüchel9, K. W. Schmidt2,10, I. Kausch6, D. Zaak7, C. Wiesner5, K. Miller11, R. Sauer3, H. Rübben1,2
1Klinik und Poliklinik für Urologie, Universitätsklinikum Essen, Essen
2Westdeutsches Tumorzentrum Essen (WTZE)
3Klinik für Strahlentherapie der Universität Erlangen
4Urologische Klinik, Städtisches Klinikum Karlsruhe GmbH, Karlsruhe
5Urologische Klinik, Johannes-Gutenberg-Universität, Mainz
6Urologische Klinik, Universitätsklinikum Kiel
7Urologische Klinik, Universitätsklinikum Großhadern
8Urologische Klinik, Helios Klinikum Wuppertal
9Institut für Pathologie, Universitätsklinikum Aachen
10Institut für Pathologie, Universitätsklinikum Essen
11Urologische Klinik, Charité, Campus Benjamin Franklin, Berlin

Tóm tắt

Liệu pháp điều trị ung thư urothelium bề mặt bao gồm cắt bỏ qua niệu đạo, trong đó đối với khối u pT1 và các khối u có độ ác tính cao, chỉ định cắt bỏ lại được đưa ra. Khi chẩn đoán Carcinoma in situ, trước tiên, sẽ thực hiện hóa trị liệu nội bàng quang hoặc liệu pháp miễn dịch; nếu điều trị không hiệu quả sau 3 tháng, sẽ khuyến nghị cắt bỏ bàng quang triệt để. Do khả năng thay thế bàng quang cho bệnh nhân một cách hợp lý về mặt chức năng, cắt bỏ bàng quang triệt để là một phương pháp điều trị hiệu quả cho các khối u bàng quang xâm lấn cơ, không di căn. Di căn hạch bạch huyết khu vực có thể thấy ở 15% bệnh nhân mắc khối u T1 và lên đến 33% ở các tổn thương T3/T4. Do đó, cắt hạch bạch huyết mang lại ý nghĩa chẩn đoán, có thể cả điều trị. Đối với những bệnh nhân được chỉ định không thể điều trị bằng cắt bỏ bàng quang triệt để, các khái niệm điều trị đa phương thức với mục tiêu bảo tồn bàng quang đang được thảo luận. Sau hoặc trước khi cắt bỏ bàng quang, hóa trị liệu toàn thân có thể cần thiết cho một phần bệnh nhân, nhằm ảnh hưởng tích cực đến diễn tiến của bệnh tiến triển tại chỗ hoặc đã di căn.

Từ khóa

#ung thư bàng quang #cắt bỏ bàng quang triệt để #điều trị đa phương thức #hóa trị liệu #hóa trị liệu nội bàng quang

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