| Revista: | International braz j urol |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000434647 |
| ISSN: | 1677-5538 |
| Autors: | Hamad, Judy1 McCloskey, Hannah1 Milowsky, Matthew I1 Royce, Trevor1 Smith, Angela2 |
| Institucions: | 1University of North Carolina, Chapel Hill School of Medicine, Chapel Hill, Carolina del Norte. Estados Unidos de América 2University of North Carolina, Lineberger Comprehensive Cancer Center, Chapel Hill, Carolina del Norte. Estados Unidos de América |
| Any: | 2020 |
| Període: | Mar-Abr |
| Volum: | 46 |
| Número: | 2 |
| País: | Brasil |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Background Standard management of muscle-invasive bladder cancer involves radical cystectomy with pelvic lymph node dissection. However, patients may be ineligible for surgery or may wish to avoid the morbidity of cystectomy due to quality of life concerns. Bladder preservation therapies have emerged as alternatives treatment options that can provide comparable oncologic outcomes while maintaining patients’ quality of life. Objective To review bladder preservation therapies, patient selection criteria, and functional and oncologic outcomes for BPT in muscle-invasive bladder cancer. Materials and Methods We conducted a comprehensive literature review of bladder preservation therapies in Pubmed and Embase. Discussion The ideal patient for BPT has low-volume T2 disease, absence of CIS, absence of hydronephrosis, and a maximal TURBT with regular surveillance. Technological advancements involving cancer staging, TURBT technique, and chemotherapy and radiation therapy regimens have improved BPT outcomes, with oncologic outcomes now comparable to those of radical cystectomy. Advancements in BPT also includes a heightened focus on improving quality of life for patients undergoing bladder preservation. Preservation strategies with most evidence for use include trimodality therapy and partial cystectomy with pelvic lymph node dissection. Conclusions This review highlights the breadth of strategies that aim to preserve a patient’s bladder while still optimizing local tumor control and overall survival. Future areas for innovation include the use of predictive biomarkers and implementation of immunotherapy, moving the field towards patient-tailored care |
| Disciplines | Medicina |
| Paraules clau: | Oncología, Urología, Terapéutica y rehabilitación, Neoplasias, Vejiga urinaria, Tratamiento conservador |
| Keyword: | Oncology, Urology, Therapeutics and rehabilitation, Neoplasms, Urinary bladder, Conservative treatment |
| Text complet: | Texto completo (Ver HTML) Texto completo (Ver PDF) |
