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Bladder cancer (4/7): Treatment Options
Review Literature: EAU guidelines: superficial bladder cancer (Babjuk et al, in 2008 and 2013). Advanced bladder cancer (Stenzl et al, 2009 and Witjes et al, 2013).
Superficial bladder cancer:
TURB with complete resection of the tumor, single shot Mitomycin after TURB, repeat resection of the scar after 4–6 weeks.
Adjuvant intravesical therapy:
Adjuvant intravesical therapy with mitomycin C or BCG depending on the risk profile according to tab. , and tab. . Repeat resection of the scar after the first treatment cycle.
With a negative histology:
intravesical maintenance therapy.
In low-grade recurrence:
further intravesical chemotherapy and repeat TURB.
In high-grade tumor recurrence:
radical cystectomy.
Invasive bladder cancer (T2–4 M0):
Radical cystectomy. Consider neoadjuvant chemotherapy for advanced bladder cancer.
After cystectomy with R0, N0, M0:.
regular cancer follow-up
After cystectomy with R1, N + or from T3b:
(neo) adjuvant chemotherapy with gemcitabine and cisplatin. Tight tumor follow-up.
urothelial carcinoma of the prostate:
radical cystoprostatectomy, orthotopic urinary diversion is not possible.
Alternatives to cystectomy:
especially in patients with high surgical risk.
Bladder carcinoma at the bladder dome:
Partial cystectomy with pelvic dissection.
Repeat radical TURB:
if a R0 resection is reached, close follow up with repeat biopsies.
Radiochemotherapy:
Radical TURB with adjuvant radiochemotherapy.
Bladder cancer with distant metastases:
Cisplatin-containing chemotherapy or immunotherapy with checkpoint inhibitors.
Bladder cancer: diagnosis | Index | Bladder cancer TURB |
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
References
Deutsche Version: Harnblasenkarzinom