ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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Current Approach Of Treatment In Muscle Invasive Bladder Tumor
Dr. Yaşar BEDÜK,a Dr. Kadir TÜRKÖLMEZa
aÜroloji AD, Ankara Üniversitesi Tıp Fakültesi, ANKARA
In this review, several clinical issues in the treatment of muscle invasive bladder cancer disease are discussed. Standard therapy for muscle invasive bladder cancer is radical cystectomy and pelvic lymphadenectomy that may be performed with an acceptably low morbidity and provides excellent local disease control. Sophisticated techniques for urinary diversion have been developed in recent years to improve patients’ quality of life. Extended lymphadenectomy has consistently shown benefit with minimal morbidity and should be considered especially in cystectomy patients that are T3. Laparoscopic radical cystectomy is a new technique as a minimal invasive approach. Safety of the technique and cancer control need to be confirmed by a larger cohort of patients. Invasive bladder cancer may be associated with occult metastasis. Approximately 50% of patients with clinically localized, invasive bladder cancer ultimately die of their disease. The radical cystectomy and lymphadenectomy alone does not always provide a satisfactory result for the disease extending outside the bladder. Neoadjuvant chemotherapy followed by radical cystectomy is one of the new standards of care for invasive, clinically nonmetastatic bladder cancer. An alternative option for muscle invasive disease may be bladder preservation by multimodality therapeutic approach, including transurethral resection, radiation therapy, and systemic chemotherapy, has been shown to produce survival rates comparable to those of radical cystectomy. However, patients who are indicated for this treatment may be limited to those with early invasive disease having certain favorable clinical and pathological features.Keywords: Invasive bladder cancer, surgery, chemotherapy, radiotherapyTurkiye Klinikleri J Surg Med Sci 2005, 1(9):27-33
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