论非肌层浸润性膀胱癌二次电切后的治疗抉择:立即全切还是继续膀胱灌注?  

Treatment strategy after a second transurethral resection for non-muscle invasive bladder cancer:immediate cystectomy or continued intravesical therapy

作　　者：范晋海[1] 杨涛 吴开杰[1] 贺大林[1] FAN Jin-hai;YANG Tao;WU Kai-jie;HE Da-lin(Department of Urology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院泌尿外科,陕西西安710061

出　　处：《现代泌尿外科杂志》2018年第4期244-247,共4页Journal of Modern Urology

摘　　要：经尿道膀胱肿瘤电切术+膀胱灌注治疗一直是非肌层浸润性膀胱癌的标准治疗方案,但其复发率和进展率居高不下,尤其是T1G3期等高危肿瘤。因此,对于高危患者,有学者建议尽早行膀胱全切术以提高患者生存率。但随着"二次电切"理念的提出,越来越多的学者建议对于高危非肌层浸润性膀胱癌患者可行二次电切术以期降低复发率和死亡率,但二次电切后仍有部分患者在短时间内复发,甚至转移。因此,在临床中如何甄别出这部分易复发甚至转移的患者至关重要。本文结合文献对二次电切后续治疗方案的抉择做简要评述,以期对临床实际工作提供依据。Transurethral resection of bladder cancer(TURB-t)plus intravesical therapy has been the first choice for non-muscle invasive bladder cancer(NMIBC);however,the rate of tumor recurrence and progression remains high,especially those high-risk tumors,such as T1G3 bladder tumor.In order to improve the survival rate,some urologists suggest immediate radical cystectomy for high-risk patients.In recent years,with the in-depth understanding of the biological characteristics of bladder cancer,a second TURB-t for high-risk patients with bladder cancer has been widely accepted.However,some patients still suffer tumor recurrence,even progression.Therefore,how to discriminate the patients is crucial.Here,based on the literature and our clinical experience,we reviewed the subsequent therapies following a second TURB-t for NMIBC in order to improve the clinical practice.

关 键 词：非肌层浸润性膀胱癌 分期 二次电切 危险因素 

分 类 号：R737.14[医药卫生—肿瘤]