nach oben

Erschienen in:

27.07.2019 | Urology - Review

Organ-sparing procedures in GU cancer: part 3-organ-sparing procedures in urothelial cancer of upper tract, bladder and urethra

verfasst von: Mahmoud I. Khalil, Jeffrey T. Alliston, Jonathan J. Bauer-Erickson, Rodney Davis, Nabil K. Bissada, Mohamed H. Kamel

Erschienen in: International Urology and Nephrology | Ausgabe 11/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The impact of radical surgery for urothelial carcinoma is significant on patient’s quality of life. Organ-sparing surgery (OSS) can provide comparable oncological outcomes and with improved quality of life. In this review, we summarize the indications, techniques and outcomes of OSS for these tumors.

Methods

PubMed^® was searched for relevant articles. Keywords used were: for upper tract urothelial carcinoma (UTUC): endoscopic, ureteroscopic/percutaneous management, laser ablation; for urothelial bladder cancer: bladder preservation, trimodal therapy, muscle invasive bladder cancer (MIBC); for urethral cancer: urethra/penile-sparing, urethral carcinoma.

Results

Kidney-sparing surgery is an option in patients with low-risk UTUC with better renal function preservation and comparable oncological control to radical nephroureterectomy. In select patients with MIBC, trimodal therapy has better quality of life and comparable oncological control to radical cystectomy. In distal male urethral cancer, penile conserving surgery is feasible and offers acceptable survival outcomes. In female urethral cancer, organ preservation can be achieved, in addition to OSS, through radiation.

Conclusions

In the appropriately selected patient, OSS in upper tract, bladder and urethral carcinoma has comparable oncological outcomes to radical surgery and with the additional benefit of improved quality of life.

Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67(1):7–30. https://doi.org/10.3322/caac.21387 CrossRefPubMed

Brien JC, Shariat SF, Herman MP, Ng CK, Scherr DS, Scoll B, Uzzo RG, Wille M, Eggener SE, Terrell JD, Lucas SM, Lotan Y, Boorjian SA, Raman JD (2010) Preoperative hydronephrosis, ureteroscopic biopsy grade and urinary cytology can improve prediction of advanced upper tract urothelial carcinoma. J Urol 184(1):69–73. https://doi.org/10.1016/j.juro.2010.03.030 CrossRefPubMed

Raman JD (2016) Kidney sparing surgery for upper-tract urothelial carcinoma. Minerva urologica e nefrologica (Ital J Urol Nephrol) 68(4):359–371

Musi G, Mistretta FA, Marenghi C, Russo A, Catellani M, Nazzani S, Conti A, Luzzago S, Ferro M, Matei DV, Carmignani L, de Cobelli O (2018) Thulium laser treatment of upper urinary tract carcinoma: a multi-institutional analysis of surgical and oncological outcomes. J Endourol 32(3):257–263. https://doi.org/10.1089/end.2017.0915 CrossRefPubMed

Clark PE, Streem SB (2004) Endourologic management of upper tract transitional cell carcinoma. Sci World J 4(Suppl 1):62–75. https://doi.org/10.1100/tsw.2004.49 CrossRef

Pan S, Smith AD, Motamedinia P (2017) Minimally invasive therapy for upper tract urothelial cell cancer. J Endourol 31(3):238–245. https://doi.org/10.1089/end.2016.0475 CrossRefPubMed

Argyropoulos AN, Tolley DA (2007) Upper urinary tract transitional cell carcinoma: current treatment overview of minimally invasive approaches. BJU Int 99(5):982–987. https://doi.org/10.1111/j.1464-410X.2007.06870.x CrossRefPubMed

Raman JD, Park R (2017) Endoscopic management of upper-tract urothelial carcinoma. Expert Rev Anticancer Ther 17(6):545–554. https://doi.org/10.1080/14737140.2017.1326823 CrossRefPubMed

Rastinehad AR, Ost MC, VanderBrink BA, Greenberg KL, El-Hakim A, Marcovich R, Badlani GH, Smith AD (2009) A 20-year experience with percutaneous resection of upper tract transitional carcinoma: is there an oncologic benefit with adjuvant bacillus Calmette Guerin therapy? Urology 73(1):27–31. https://doi.org/10.1016/j.urology.2008.06.026 CrossRefPubMed

10.

Foerster B, D’Andrea D, Abufaraj M, Broenimann S, Karakiewicz PI, Roupret M, Gontero P, Lerner SP, Shariat SF, Soria F (2019) Endocavitary treatment for upper tract urothelial carcinoma: a meta-analysis of the current literature. Urol Oncol 37(7):430–436. https://doi.org/10.1016/j.urolonc.2019.02.004 CrossRefPubMed

11.

Donin NM, Duarte S, Lenis AT, Caliliw R, Torres C, Smithson A, Strauss-Ayali D, Agmon-Gerstein Y, Malchi N, Said J, Raman SS, Holden S, Pantuck A, Belldegrun AS, Chamie K (2017) Sustained-release formulation of mitomycin C to the upper urinary tract using a thermosensitive polymer: a preclinical study. Urology 99:270–277. https://doi.org/10.1016/j.urology.2016.09.039 CrossRefPubMed

12.

Fang D, Seisen T, Yang K, Liu P, Fan X, Singla N, Xiong G, Zhang L, Li X, Zhou L (2016) A systematic review and meta-analysis of oncological and renal function outcomes obtained after segmental ureterectomy versus radical nephroureterectomy for upper tract urothelial carcinoma. Eur J Surg Oncol 42(11):1625–1635. https://doi.org/10.1016/j.ejso.2016.08.008 CrossRefPubMed

13.

Kocot A, Kalogirou C, Vergho D, Riedmiller H (2017) Long-term results of ileal ureteric replacement: a 25-year single-centre experience. BJU Int 120(2):273–279. https://doi.org/10.1111/bju.13825 CrossRefPubMed

14.

Villa L, Cloutier J, Letendre J, Ploumidis A, Salonia A, Cornu JN, Montorsi F, Traxer O (2016) Early repeated ureteroscopy within 6–8 weeks after a primary endoscopic treatment in patients with upper tract urothelial cell carcinoma: preliminary findings. World J Urol 34(9):1201–1206. https://doi.org/10.1007/s00345-015-1753-7 CrossRefPubMed

15.

Seisen T, Colin P, Roupret M (2015) Risk-adapted strategy for the kidney-sparing management of upper tract tumours. Nat Rev Urol 12(3):155–166. https://doi.org/10.1038/nrurol.2015.24 CrossRefPubMed

16.

Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester RJ, Burger M, Cowan NC, Gontero P, Van Rhijn BWG, Mostafid AH, Palou J, Shariat SF (2018) European Association of Urology Guidelines on upper urinary tract urothelial carcinoma: 2017 update. Eur Urol 73(1):111–122. https://doi.org/10.1016/j.eururo.2017.07.036 CrossRefPubMed

17.

Smith P, Mandel J, Raman JD (2013) Conservative nephron-sparing treatment of upper-tract tumors. Curr Urol Rep 14(2):102–108. https://doi.org/10.1007/s11934-013-0305-1 CrossRefPubMed

18.

Wissing MD, Santos F, Zakaria AS, O’Flaherty A, Tanguay S, Kassouf W, Aprikian AG (2019) Short- and long-term survival has improved after radical cystectomy for bladder cancer in Quebec during the years 2000–2015. J Surg Oncol 119(8):1135–1144. https://doi.org/10.1002/jso.25456 CrossRefPubMed

19.

Biagioli MC, Fernandez DC, Spiess PE, Wilder RB (2013) Primary bladder preservation treatment for urothelial bladder cancer. Cancer Control J Moffitt Cancer Cent 20(3):188–199. https://doi.org/10.1177/107327481302000307 CrossRef

20.

Moran GW, Li G, Robins DJ, Matulay JT, McKiernan JM, Anderson CB (2017) Systematic review and meta-analysis on the efficacy of chemotherapy with transurethral resection of bladder tumors as definitive therapy for muscle invasive bladder cancer. Bladder Cancer (Amst Neth) 3(4):245–258. https://doi.org/10.3233/blc-170134 CrossRef

21.

Leibovici D, Kassouf W, Pisters LL, Pettaway CA, Wu X, Dinney CP, Grossman HB (2007) Organ preservation for muscle-invasive bladder cancer by transurethral resection. Urology 70(3):473–476. https://doi.org/10.1016/j.urology.2007.05.007 CrossRefPubMed

22.

Herr HW (2001) Transurethral resection of muscle-invasive bladder cancer: 10-year outcome. J Clin Oncol 19(1):89–93. https://doi.org/10.1200/JCO.2001.19.1.89 CrossRefPubMed

23.

Smith ZL, Christodouleas JP, Keefe SM, Malkowicz SB, Guzzo TJ (2013) Bladder preservation in the treatment of muscle-invasive bladder cancer (MIBC): a review of the literature and a practical approach to therapy. BJU Int 112(1):13–25. https://doi.org/10.1111/j.1464-410X.2012.11762.x CrossRefPubMed

24.

Grossman HB, Natale RB, Tangen CM, Speights VO, Vogelzang NJ, Trump DL, deVere White RW, Sarosdy MF, Wood DP Jr, Raghavan D, Crawford ED (2003) Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 349(9):859–866. https://doi.org/10.1056/NEJMoa022148 CrossRefPubMed

25.

Petrelli F, Coinu A, Cabiddu M, Ghilardi M, Vavassori I, Barni S (2014) Correlation of pathologic complete response with survival after neoadjuvant chemotherapy in bladder cancer treated with cystectomy: a meta-analysis. Eur Urol 65(2):350–357. https://doi.org/10.1016/j.eururo.2013.06.049 CrossRefPubMed

26.

Williams SB, Shan Y, Ray-Zack MD, Hudgins HK, Jazzar U, Tyler DS, Freedland SJ, Swanson TA, Baillargeon JG, Hu JC, Kaul S, Kamat AM, Gore JL, Mehta HB (2019) Comparison of costs of radical cystectomy vs trimodal therapy for patients with localized muscle-invasive bladder cancer. JAMA Surg. https://doi.org/10.1001/jamasurg.2019.1629 CrossRefPubMedPubMedCentral

27.

Choudhury A, Swindell R, Logue JP, Elliott PA, Livsey JE, Wise M, Symonds P, Wylie JP, Ramani V, Sangar V, Lyons J, Bottomley I, McCaul D, Clarke NW, Kiltie AE, Cowan RA (2011) Phase II study of conformal hypofractionated radiotherapy with concurrent gemcitabine in muscle-invasive bladder cancer. J Clin Oncol 29(6):733–738. https://doi.org/10.1200/JCO.2010.31.5721 CrossRefPubMed

28.

Hagan MP, Winter KA, Kaufman DS, Wajsman Z, Zietman AL, Heney NM, Toonkel LM, Jones CU, Roberts JD, Shipley WU (2003) RTOG 97-06: initial report of a phase I-II trial of selective bladder conservation using TURBT, twice-daily accelerated irradiation sensitized with cisplatin, and adjuvant MCV combination chemotherapy. Int J Radiat Oncol Biol Phys 57(3):665–672CrossRef

29.

Kaufman DS, Winter KA, Shipley WU, Heney NM, Wallace HJ 3rd, Toonkel LM, Zietman AL, Tanguay S, Sandler HM (2009) Phase I-II RTOG study (99-06) of patients with muscle-invasive bladder cancer undergoing transurethral surgery, paclitaxel, cisplatin, and twice-daily radiotherapy followed by selective bladder preservation or radical cystectomy and adjuvant chemotherapy. Urology 73(4):833–837. https://doi.org/10.1016/j.urology.2008.09.036 CrossRefPubMed

30.

Mak RH, Hunt D, Shipley WU, Efstathiou JA, Tester WJ, Hagan MP, Kaufman DS, Heney NM, Zietman AL (2014) Long-term outcomes in patients with muscle-invasive bladder cancer after selective bladder-preserving combined-modality therapy: a pooled analysis of Radiation Therapy Oncology Group protocols 8802, 8903, 9506, 9706, 9906, and 0233. J Clin Oncol 32(34):3801–3809. https://doi.org/10.1200/JCO.2014.57.5548 CrossRefPubMedPubMedCentral

31.

James ND, Hussain SA, Hall E, Jenkins P, Tremlett J, Rawlings C, Crundwell M, Sizer B, Sreenivasan T, Hendron C, Lewis R, Waters R, Huddart RA, Investigators BC (2012) Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med 366(16):1477–1488. https://doi.org/10.1056/NEJMoa1106106 CrossRefPubMed

32.

Mitin T, Hunt D, Shipley WU, Kaufman DS, Uzzo R, Wu CL, Buyyounouski MK, Sandler H, Zietman AL (2013) Transurethral surgery and twice-daily radiation plus paclitaxel-cisplatin or fluorouracil-cisplatin with selective bladder preservation and adjuvant chemotherapy for patients with muscle invasive bladder cancer (RTOG 0233): a randomised multicentre phase 2 trial. Lancet Oncol 14(9):863–872. https://doi.org/10.1016/S1470-2045(13)70255-9 CrossRefPubMedPubMedCentral

33.

Zietman AL, Sacco D, Skowronski U, Gomery P, Kaufman DS, Clark JA, Talcott JA, Shipley WU (2003) Organ conservation in invasive bladder cancer by transurethral resection, chemotherapy and radiation: results of a urodynamic and quality of life study on long-term survivors. J Urol 170(5):1772–1776. https://doi.org/10.1097/01.ju.0000093721.23249.c3 CrossRefPubMed

34.

Balar AV, Castellano D, O’Donnell PH, Grivas P, Vuky J, Powles T, Plimack ER, Hahn NM, de Wit R, Pang L, Savage MJ, Perini RF, Keefe SM, Bajorin D, Bellmunt J (2017) First-line pembrolizumab in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urothelial cancer (KEYNOTE-052): a multicentre, single-arm, phase 2 study. Lancet Oncol 18(11):1483–1492. https://doi.org/10.1016/S1470-2045(17)30616-2 CrossRefPubMed

35.

Sharma P, Retz M, Siefker-Radtke A, Baron A, Necchi A, Bedke J, Plimack ER, Vaena D, Grimm MO, Bracarda S, Arranz JA, Pal S, Ohyama C, Saci A, Qu X, Lambert A, Krishnan S, Azrilevich A, Galsky MD (2017) Nivolumab in metastatic urothelial carcinoma after platinum therapy (CheckMate 275): a multicentre, single-arm, phase 2 trial. Lancet Oncol 18(3):312–322. https://doi.org/10.1016/S1470-2045(17)30065-7 CrossRefPubMed

36.

Jiang DM, Jiang H, Chung PWM, Zlotta AR, Fleshner NE, Bristow RG, Berlin A, Kulkarni GS, Alimohamed NS, Lo G, Sridhar SS (2019) Neoadjuvant chemotherapy before bladder-sparing chemoradiotherapy in patients with nonmetastatic muscle-invasive bladder cancer. Clin Genitourin Cancer 17(1):38–45. https://doi.org/10.1016/j.clgc.2018.09.021 CrossRefPubMed

37.

Fedeli U, Fedewa SA, Ward EM (2011) Treatment of muscle invasive bladder cancer: evidence from the National Cancer Database, 2003 to 2007. J Urol 185(1):72–78. https://doi.org/10.1016/j.juro.2010.09.015 CrossRefPubMed

38.

Knoedler JJ, Boorjian SA, Kim SP, Weight CJ, Thapa P, Tarrell RF, Cheville JC, Frank I (2012) Does partial cystectomy compromise oncologic outcomes for patients with bladder cancer compared to radical cystectomy? A matched case-control analysis. J Urol 188(4):1115–1119. https://doi.org/10.1016/j.juro.2012.06.029 CrossRefPubMed

39.

Bazzi WM, Kopp RP, Donahue TF, Bernstein M, Russo P, Bochner BH, Donat SM, Dalbagni G, Herr HW (2014) Partial cystectomy after neoadjuvant chemotherapy: Memorial Sloan Kettering Cancer Center contemporary experience. Int Sch Res Not 2014:702653. https://doi.org/10.1155/2014/702653 CrossRefPubMedPubMedCentral

40.

Ma B, Li H, Zhang C, Yang K, Qiao B, Zhang Z, Xu Y (2013) Lymphovascular invasion, ureteral reimplantation and prior history of urothelial carcinoma are associated with poor prognosis after partial cystectomy for muscle-invasive bladder cancer with negative pelvic lymph nodes. Eur J Surg Oncol 39(10):1150–1156. https://doi.org/10.1016/j.ejso.2013.04.006 CrossRefPubMed

41.

Bruins HM, Wopat R, Mitra AP, Cai J, Miranda G, Skinner EC, Daneshmand S (2013) Long-term outcomes of salvage radical cystectomy for recurrent urothelial carcinoma of the bladder following partial cystectomy. BJU Int 111(3B):E37–E42. https://doi.org/10.1111/j.1464-410X.2012.11438.x CrossRefPubMed

42.

Chang SS, Bochner BH, Chou R, Dreicer R, Kamat AM, Lerner SP, Lotan Y, Meeks JJ, Michalski JM, Morgan TM, Quale DZ, Rosenberg JE, Zietman AL, Holzbeierlein JM (2017) Treatment of non-metastatic muscle-invasive bladder cancer: AUA/ASCO/ASTRO/SUO guideline. J Urol 198(3):552–559. https://doi.org/10.1016/j.juro.2017.04.086 CrossRefPubMedPubMedCentral

43.

Flaig TW, Spiess PE, Agarwal N, Bangs R, Boorjian SA, Buyyounouski MK, Downs TM, Efstathiou JA, Friedlander T, Greenberg RE, Guru KA, Hahn N, Herr HW, Hoimes C, Inman BA, Jimbo M, Kader AK, Lele SM, Meeks JJ, Michalski J, Montgomery JS, Pagliaro LC, Pal SK, Patterson A, Petrylak DP, Plimack ER, Pohar KS, Porter MP, Preston MA, Sexton WJ, Siefker-Radtke AO, Tward J, Wile G, Johnson-Chilla A, Dwyer MA, Gurski LA (2018) NCCN guidelines insights: bladder cancer, Version 5.2018. J Natl Compr Cancer Netw 16(9):1041–1053. https://doi.org/10.6004/jnccn.2018.0072 CrossRef

44.

Swartz MA, Porter MP, Lin DW, Weiss NS (2006) Incidence of primary urethral carcinoma in the United States. Urology 68(6):1164–1168. https://doi.org/10.1016/j.urology.2006.08.1057 CrossRefPubMed

45.

Smith Y, Hadway P, Ahmed S, Perry MJ, Corbishley CM, Watkin NA (2007) Penile-preserving surgery for male distal urethral carcinoma. BJU Int 100(1):82–87. https://doi.org/10.1111/j.1464-410X.2007.06901.x CrossRefPubMed

46.

Taylor JH, Davis J, Schellhammer P (2007) Long-term follow-up of intravesical bacillus Calmette–Guerin treatment for superficial transitional-cell carcinoma of the bladder involving the prostatic urethra. Clin Genitourin Cancer 5(6):386–389. https://doi.org/10.3816/CGC.2007.n.021 CrossRefPubMed

47.

Garden AS, Zagars GK, Delclos L (1993) Primary carcinoma of the female urethra. Results of radiation therapy. Cancer 71(10):3102–3108CrossRef

48.

Gakis G, Witjes JA, Comperat E, Cowan NC, De Santis M, Lebret T, Ribal MJ, Sherif AM (2013) EAU guidelines on primary urethral carcinoma. Eur Urol 64(5):823–830. https://doi.org/10.1016/j.eururo.2013.03.044 CrossRefPubMed

Titel: Organ-sparing procedures in GU cancer: part 3-organ-sparing procedures in urothelial cancer of upper tract, bladder and urethra
verfasst von: Mahmoud I. Khalil
Jeffrey T. Alliston
Jonathan J. Bauer-Erickson
Rodney Davis
Nabil K. Bissada
Mohamed H. Kamel
Publikationsdatum: 27.07.2019
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 11/2019
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-019-02232-z

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2019

Scintigraphic evaluation of remote pre-conditioning protection against unilateral renal ischemia/reperfusion injury in rats: a longitudinal study

Efficacy and safety of desmopressin in women with nocturia: a systematic review and meta-analysis of randomized controlled trials

Ultrasound-assisted microsurgical left spermatic-inferior epigastric vein anastomosis for treating nutcracker syndrome-associated varicocele

Intravesical stent position as a predictor of quality of life in patients with indwelling ureteral stent

Efficacy and safety of leflunomide in IgA nephropathy: a systematic review and meta-analysis