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01.12.2007 | Leitthema

Stellenwert der transurethralen Resektion und Instillationstherapie beim Harnblasenkarzinom

verfasst von: PD Dr. I. Kausch, D. Jocham

Erschienen in: Die Onkologie | Ausgabe 12/2007

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Zusammenfassung

70–80% der neu diagnostizierten Harnblasenkarzinome sind auf die Mukosa begrenzt und werden nach der TNM-Klassifikation von 2002 als Ta, T1 oder Cis eingeteilt. Die Standardbehandlung dieser nichtmuskelinvasiven Tumoren besteht zunächst in der transurethralen Resektion (TUR), die einerseits nach pathologischer Befundung diagnostische Staging-Informationen liefert und andererseits therapeutischen Charakter hat. Bei allen T1-Tumoren und bei nicht sicher komplett resezierten Ta-Tumoren wird eine wiederholte (R0) Resektion empfohlen. Aufgrund hoher Rezidivraten und zumindest bei schlecht differenzierten Tumoren auch aufgrund hoher Progressionsraten wird üblicherweise nach TUR eine adjuvante intravesikale Instillationstherapie durchgeführt. Während bei „Low-Risk“-Ta-Tumoren meist eine einmalige Chemotherapie-Frühinstillation ausreicht, ist bei größeren oder schnell rezidivierenden Ta-Tumoren eine zusätzliche Induktionstherapie sowie ggf. auch eine Erhaltungstherapie sinnvoll. Tumoren mit hohem Rezidiv- und Progressrisiko (T1 oder „high grade“) sind eine Domäne der intravesikalen Immuntherapie mit BCG (Bacillus Calmette-Guérin).
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Metadaten
Titel
Stellenwert der transurethralen Resektion und Instillationstherapie beim Harnblasenkarzinom
verfasst von
PD Dr. I. Kausch
D. Jocham
Publikationsdatum
01.12.2007
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 12/2007
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-007-1283-z

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