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Erschienen in:

25.01.2019 | Topic Paper

SIU–ICUD consultation on bladder cancer: treatment of muscle-invasive bladder cancer

verfasst von: Jeffrey J. Leow, Jens Bedke, Karim Chamie, Justin W. Collins, Siamak Daneshmand, Petros Grivas, Axel Heidenreich, Edward M. Messing, Trevor J. Royce, Alexander I. Sankin, Mark P. Schoenberg, William U. Shipley, Arnauld Villers, Jason A. Efstathiou, Joaquim Bellmunt, Arnulf Stenzl

Erschienen in: World Journal of Urology | Ausgabe 1/2019

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Abstract

Purpose

To provide a comprehensive overview and update of the Joint Société Internationale d’Urologie–International Consultation on Urological Diseases (SIU–ICUD) Consultation on Bladder Cancer for muscle-invasive presumably node-negative bladder cancer (MIBC).

Methods

Contemporary literature was analyzed for the latest evidence in treatment options, outcomes, including radical surgery, neoadjuvant and adjuvant treatment modalities, and bladder-sparing approaches. An international multi-disciplinary expert panel evaluated and graded the data according to guidelines from the Oxford Centre for Evidence-Based Medicine.

Results

Radical cystectomy (RC) is the standard of care for MIBC patients considered to be surgical candidates. While associated with substantial morbidity and mortality, this has been mitigated with improved technique, minimally invasive technology, and better perioperative care pathways (e.g., enhanced recovery after surgery). Neoadjuvant (NA) cisplatin-based combination chemotherapy improves overall survival and should be offered to eligible ≥ cT2N0 patients. Adjuvant (Adj) cisplatin-based combination chemotherapy may be considered, particularly for pT3–4 and/or pN+ disease without prior NA chemotherapy. Trimodal bladder-preserving treatment via maximum transurethral resection of bladder tumor followed by concurrent chemoradiation is safe and, when combined with early salvage RC for recurrence, offers long-term survival rates in selected patients comparable to RC. Immunotherapy is still experimental and is given either alone or in combination with chemotherapy and/or radiation.

Conclusion

A multi-disciplinary approach is paramount to achieving optimal outcomes for MIBC patients, irrespective of their age, performance and nutritional status, fitness/frailty, renal and other organ function, or disease severity.

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Titel: SIU–ICUD consultation on bladder cancer: treatment of muscle-invasive bladder cancer
verfasst von: Jeffrey J. Leow
Jens Bedke
Karim Chamie
Justin W. Collins
Siamak Daneshmand
Petros Grivas
Axel Heidenreich
Edward M. Messing
Trevor J. Royce
Alexander I. Sankin
Mark P. Schoenberg
William U. Shipley
Arnauld Villers
Jason A. Efstathiou
Joaquim Bellmunt
Arnulf Stenzl
Publikationsdatum: 25.01.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 1/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2606-y

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SIU–ICUD consultation on bladder cancer: treatment of muscle-invasive bladder cancer

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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