目的:低度(LG)尿路上皮局限(Ta期)非肌肉浸润性膀胱癌(NMIBC)的治疗提出了独特的治疗挑战。经尿道膀胱肿瘤电切术(TURBT),标准治疗,由于肿瘤复发率高,经常不得不重复。这给患者和医疗保健基础设施带来了相当大的压力,强调了对替代管理方法的需求。在这里,IBCG(国际膀胱癌组织),进行了综述,以探讨复发性LGTaNMIBC的强化治疗策略的有效性和安全性。
方法:我们对PubMed/MEDLINE和CochraneCENTRAL数据库中的相关文献进行了合作回顾。我们的重点是高质量的证据,包括随机对照试验,系统评价,和荟萃分析。我们还审查了著名泌尿外科协会发布的指南。
■主动监控,化学消融,和办公室电疗是复发性LGTaNMIBC的有效治疗选择。与TURBT相比,这些去强化的方法有几个优点:并发症发生率较低,发病率较低,更低的医疗费用,以及更好的患者生活质量。重要的是,这些益处是在不影响肿瘤安全性的情况下实现的。
结论:我们的综述表明,对于复发性LGTaNMIBC的低强度治疗策略是可行且有价值的。IBCG建议将这些方法用于精心选择的患者,以帮助降低医疗保健成本并提高患者的生活质量。
结果:我们回顾了低级别非浸润性膀胱癌的微创治疗方案的研究,包括主动监测,化学消融,和热处理。最近的结果证实,这些强度较低的治疗方案可以减轻患者的治疗负担和成本,并保持他们的生活质量,而不会对癌症控制结果产生负面影响。
OBJECTIVE: Management of low-grade (LG) urothelium-confined (Ta stage) non-muscle-invasive bladder cancer (NMIBC) poses a distinct therapeutic challenge. Transurethral resection of bladder tumor (TURBT), the standard treatment, frequently has to be repeated because of high tumor recurrence rates. This places a considerable strain on both patients and health care infrastructure, underscoring the need for alternative management approaches. Herein, the IBCG (International Bladder Cancer Group), conducted a
review to explore the efficacy and safety of deintensified treatment strategies for recurrent LG Ta NMIBC.
METHODS: We conducted a collaborative
review of relevant literature in the PubMed/MEDLINE and Cochrane CENTRAL databases. Our focus was on high-quality evidence, including randomized controlled trials, systematic reviews, and meta-analyses. We also reviewed guidelines published by prominent urological associations.
UNASSIGNED: Active surveillance, chemoablation, and office fulguration are valid treatment options for recurrent LG Ta NMIBC. These deintensified approaches offer several advantages over TURBT: lower complication rates, less morbidity, lower health care costs, and better quality of life for patients. Importantly, these benefits are achieved without compromising oncological safety.
CONCLUSIONS: Our
review demonstrates that less intensive treatment strategies for recurrent LG Ta NMIBC are both feasible and valuable. The IBCG recommends use of these approaches for carefully selected patients to help lower health care costs and enhance patients\' quality of life.
RESULTS: We reviewed studies on less invasive management options for low-grade noninvasive bladder cancer, including active surveillance, chemical ablation, and heat treatment. Recent results confirm that these less intense treatment options can reduce the treatment burden and costs for patients and preserve their quality of life without negatively affecting cancer control outcomes.