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🌱來自: urothelial carcinoma

Management of Muscle invasive UC

Radical cystectomy is tx of choice for muscle invasive dz w/ urinary diversion Neoadjuvant cisplatin-based chemo prior to cystectomy improves OS (NEJM 2003;349:859; Lancet 2003;361:1927). Regimens include dose-dense (dd)MVAC methotrexate, vinblastine, doxorubicin, cisplatin (JCO 2014;32:1895; JCO 2014;32:1889) or GC-gemcitabine, cisplatin (Clin Genitourin Cancer 2020;18:387) Bladder preservation options include trimodality tx: TURBT, followed by concurrent chemoradiation (NEJM 2012;366:1477). Pt selection key, w/ up to 40% requiring cystectomy for tx failure or dz recurrence. Criteria: Eligibility for complete TURBT, adequate bladder fxn, UC histology, early stage (T2), no multifocal dz & no hydronephrosis No completed prospective RCT establishes adjuvant chemo after radical cystectomy, though meta-analyses show survival benefit (Eur Urol 2014;66:42) Emerging data in high-risk pts shows ↑ disease free survival (DFS) w/ adjuvant nivolumab (N Engl J Med 2021;384:2102)

Siblings

• Epidemiology-of-urothelial carcinoma
• Etiology and clinical manifestations-of-urothelial carcinoma
• Pathologic Subtypes-of-urothelial carcinoma
• Workup-of-urothelial carcinoma
• Staging and prognosis-of-urothelial carcinoma
• Management of Nonmuscle invasive UC
• Management of Muscle invasive UC
• Management Metastatic UC
• Cancers of the renal pelvis and ureter
• Molecular biology and targeted therapy-of-urothelial carcinoma