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Therapie und Nachsorge bei malignen Blasentumoren

Therapy and follow-up of bladder cancer

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Summary

Treatment and follow up of bladder cancer strongly depends on stage and differentiation of the tumour. Superficial bladder tumours can mostly be controlled by transurethral resection followed by early intravesical application of a chemotherapeutic agent and a further close meshed follow-up. Generally, for muscle-invasive tumours radical cystectomy is indicated, whereas organ-spearing treatment due to combined therapeutic concepts can be offered in selected cases. For advanced and metastatic tumours, despite good response of bladder cancer to chemotherapy, prognosis is still poor. However, implementation of new chemotherapeutic agents indicate a trend towards improved survival rates.

Zusammenfassung

Die Therapie und Nachsorge des Blasenkarzinoms richtet sich stark nach dessen Stadium und Differenzierung. Die oberflächlichen Blasentumoren lassen sich grösstenteils organerhaltend durch eine transurethrale Resektion, ergänzt durch eine intravesikal applizierte Frühinstillation eines Chemotherapeutikums und gefolgt von einer engmaschigen Nachsorge beherrschen. Bei den muskelinvasiven Tumoren ist in der Regel die radikale Zystekomie indiziert, wobei mit neuen kombinierten Behandlungskonzepten in ausgewählten Fällen auch organerhaltend therapiert werden kann. Die lokal fortgeschrittenen und metastasierten Blasenkarzinome haben trotz guter Ansprechraten der Chemotherapeutika weiterhin eine sehr ungünstige Prognose, aber auch hier zeigt sich durch neu eingesetzte Substanzen eine tendenzielle Verbesserung des Gesamtüberlebens.

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  1. Klinik für Urologie, Kantonsspital St. Gallen, St. Gallen, Switzerland

    Daniel Meyer, Hans-Peter Schmid & Daniel S. Engeler

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  1. Daniel Meyer
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Correspondence to Daniel Meyer.

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Meyer, D., Schmid, HP. & Engeler, D. Therapie und Nachsorge bei malignen Blasentumoren. Wien Med Wochenschr 157, 162–169 (2007). https://doi.org/10.1007/s10354-007-0381-2

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