Which Patients Should Undergo Immediate or Deferred Cystectomy in Non-Muscle Invazive Bladder Cancer? Evaluation of Selection Criteria
Journal Title: Üroonkoloji Bülteni - Year 2016, Vol 15, Issue 1
Abstract
Bladder cancer is the most common malignancy of the urinary tract in Europe. 70% of all muscle invasive is bladder cancer (MIBC) at the time of diagnosis whereas remaining 30% is non-muscle invasive bladder cancer (NMIBC). NMIBC patients with low-risk can be treated with complete transurethral resection of bladder tumor (TUR-BT) and perioperative single-dose adjuvant chemotherapeutic instillation; whilst TUR-BT and bacille calmette guerin (or mitomycin) treatment are usually used in patient management with high-risk tumor. Radical cystectomy may be the choice of treatment in high-risk NMIBC. Although radical cystectomy is the definitive treatment of MIBC, its role and timing in NMIBC is still remains unclear. Early and deferred cystectomy refers two different cystectomy concepts in NMIBC without a definitive time threshold. Early cystectomy defines cystectomy in a short time span following pathologic diagnosis, whereas cystectomy performed after bladder-sparing surgery is a deferred cystectomy. Despite the difference between these studies in regard to design and outcomes, most of the conducted studies have shown immediate cystectomy to be superior to deferred cystectomy with favorable survival rates. According to previous studies and a meta-analysis, depth of invasion in lamina propria and presence of carcinoma in situ have shown to be the most significant factors supporting immediate cystectomy. Increased knowledge and surgical experience, the advantages of robotic surgery as well as orthotopic urinary diversions being used more common are some factors which may encourage clinicians and patients in decision making for an early cystectomy with functional and aesthetic advantages.
Authors and Affiliations
Şenol Tonyalı, Mustafa Sertaç Yazıcı
Keywords
Related Articles
- EP ID EP228268
- DOI 10.4274/uob.536
- Views 98
- Downloads 0
Do the Pain Scores During Transrectal Ultrasound-guided Prostate Rebiopsy Change in Patients with a Prior History of Prostate Biopsy?
Objective: In this study we evaluated the effects of prior history of prostate biopsy on pain scores of patients who underwent transrectal ultrasound-guided prostate biopsy (TRUS-PBx). Materials and Methods: Between Octo...
Partial Urethrectomy for Female Urethral Transitional Epithelial Cell Carcinoma
To present a female case of partial urethrectomy and the following adjuvant chemo-radio-therapy for urethral transitional epithelial cell carcinoma originating from distal urethra in the light of literature. The patient...
The Incidence of Prostate Adenocarcinoma in Patients Who Underwent Cystoprostatectomy for Invasive Baldder Cancer and Histopathological Examination
Objective: It was aimed to evaluate the incidence of prostate adenocarcinoma in patients treated by cystoprostatectomy for invasive bladder urothelial carcinoma and to demonstrate the histopathological features of prosta...
Immunohistochemical Study of Cyclooxygenase-2 Expression in Prostate Carcinoma: It’s Relation with Apoptosis and Angiogenesis
Objective: Prostate carcinoma (PC) is one of the most commonly diagnosed cancer types with significant rates of mortality and morbidity. The etiology of PC is not clear. Cytokine and mediators at the inflammatory pathway...
Transurethral Resection of the Bladder Tumor Success Rates of Surgeons and Possible Causes of Differences Between Locals and Refugees
Objective: In our study, we examined the success rates of our surgeons and the criteria that define the success, and tried to reveal the possible causes of the differences in the success rates of transurethral resection...