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 68
- Downloads 0
Bellini Duct Carcinoma: Case Report and Review of the Literature
Bellini duct carcinoma is highly aggressive tumor with poor prognosis. Metastases develop in most patients. Early diagnosis is very important and might increase the patient’s life span. Various treatment protocols includ...
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...
Impact of Delay from Biopsy to Surgery on the Rate of Adverse Pathologic and Oncologic Outcomes for Clinically Localized Prostate Cancer
Objective: Due to the widespread usage of prostate-specific antigen screening, the number of patients diagnosed with prostate cancer is steadily increasing. Many factors such as high operating room demand, insurance reim...
Magnetic Resonance Imaging Findings of Multilocular Cystic Renal Cell Carcinoma and Clinical-pathologic Comparison
Objective: Multilocular cystic renal cell carcinoma (RCC) is a unique type of renal carcinoma characterized by multi-loculated cystic masses. The aim of this study was to retrospectively evaluate the magnetic resonance i...
The Presence and Thickness of Pseudocapsule after Partial Nephrectomy in Renal Cell Carcinoma
Objective: In this study, we aimed to evaluate the presence and thickness of pseudocapsule after partial nephrectomy in renal cell carcinoma (RCC) cases. Materials and Methods: A total of 100 patients who were admitted t...