摘要
膀胱癌是泌尿外科常见的恶性肿瘤之一。膀胱尿路上皮癌约占所有膀胱恶性肿瘤的90%,根据肿瘤是否侵犯膀胱肌层可分为非肌层浸润性膀胱癌和肌层浸润性膀胱癌。根治性膀胱切除术是肌层浸润性膀胱癌和卡介苗治疗失败的高危非肌层浸润性膀胱癌的标准治疗方法。由于患者自身基础疾病以及手术导致的生活质量下降,许多患者不适合或拒绝根治性膀胱切除术。寻找根治性膀胱切除术以外能够达到治愈的、保留膀胱的治疗方案显得极为重要。保膀胱治疗在一定程度上平衡了肿瘤控制和生活质量,是根治性膀胱切除术的替代及补充。共识根据国内外循证医学依据,结合目前中国膀胱癌保膀胱治疗的临床实践与应用经验,以多学科诊疗模式为基础,重点探讨了保膀胱多学科诊疗的组织架构和工作流程、保膀胱治疗的患者选择、治疗方案、随访监测以及保膀胱治疗复发后的方案选择,以期为国内膀胱癌的保膀胱治疗提供一定指导意见。
Objective Bladder cancer is one of the most common malignant tumors in urology.Urothelial carcinoma accounts for about 90%of all bladder malignancies.According to whether the tumor invades the bladder muscle,it can be divided into non-muscle invasive bladder cancer and muscle invasive bladder cancer.Radical cystectomy is the standard treatment for muscle invasive bladder cancer patients and high-risk non-muscle invasive bladder cancer patients who have failed Bacillus Calmette-Guerin treatment.Due to the comorbidity of bladder cancer and the potential deterioration of the quality of life after surgery,many patients were not suitable or refused for radical cystectomy.Therefore,it is vital to find a bladder-preserving treatment that can achieve cure other than radical cystectomy.Bladder-preserving therapy that balances tumor control and quality of life serves as an alternative and supplement to radical cystectomy.This consensus is based on contemporary evidence-based medicine,combined with the native clinical practice of bladder preservation in a multidisciplinary treatment manner.To some extent,this consensus serves as a guidance for bladder-preservation therapy of bladder cancer in China.Several issues are extensively discussed here,including organizational structure and workflow of multidisciplinary treatment,the selection of patients for bladder-preserving therapy,treatment options and regimens,follow-up,as well as regimen choices of recurrence after bladder-preserving therapy.
作者
中国肿瘤医院泌尿肿瘤协作组
叶定伟
Urological Chinese Oncology Group;Ye Dingwei(不详;Department of Urology,Fudan University Shanghai Cancer Center and Department of Oncology,Fudan University,Shanghai 200032,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2022年第3期209-218,共10页
Chinese Journal of Oncology
关键词
膀胱肿瘤
保留膀胱
多学科治疗
专家共识
Bladder neoplasms
Bladder preservation
Multi-disciplinary treatment
Expert consensus
