Preview

Cancer Urology

Advanced search

Choice of the optimal treatment strategy for patient with multifocal bladder cancer: clinical case

https://doi.org/10.17650/1726-9776-2015-11-4-102-106

Abstract

Transurethral resection of bladder is the standard surgical procedure for management of bladder cancer when it is suspected. Accurate clinical staging of the disease based on the histologic findings followed by further assessment of recurrence risks and risks of disease progression are vital for defining an optimal individualized treatment strategy. Early radical cystectomy (RC) is recommended for patients suffering from superficial bladder cancer at high risk for tumor recurrence.

Patients diagnosed with bladder tumors with multifocal lesions as well as with tumor size > 3 сm are related to a group of high risk for cancer progression. In this case in order to take a decision about the benefits of radical surgery, it’s essential to remember that RC is considered to be a major surgical procedure with a broad range of both intraoperative and postoperative complications. The vast majority of patients experience a lower quality of life based on the development of different types of metabolic alterations as well as the necessity for using urinals or inability to have adequate urination control. Organ-preserving therapy with active follow-up is thereby preferably to conduct on young patients with active life position.

In our clinical case we confirmed that such treatment strategy allows to establish adequate control over neoplastic process with less negative impact on patients’ quality of life.

About the Authors

I. А. Reva
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


А. V. Bormotin
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


Е. А. Prilepskaya
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


М. V. Kovylina
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


А. N. Bernikov
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


N. V. Tupikina
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


О. A. Tsybulya
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


D. Yu. Pushkar
Department of Urology “Moscow State Medico-stomatological University named after A.I. Evdokimov”; 21/2 Vucheticha St., Moscow, 125206, Russia
Russian Federation


References

1. Ferlay J., Bray F., Forman D. et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 10 2010, International Agency for Research on Cancer: Lyon, France.

2. Burger M., Catto J.W., Dalbagni G. et al. Epidemiology and risk factors of urothelial bladder cancer. EurUrol 2013;63(2):234–41.

3. Brausi M., Collette L., Kurth K. et al. EORTC Genito-Urinary Tract Cancer Collaborative Group. Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol 2002;41(5):523–31.

4. Mariappan P., Finney S.M., Head E. et al. Good quality white-light transurethral resection of bladder tumours (GQ-WLTURBT) with experienced surgeons performing complete resections and obtaining detrusor muscle reduces early recurrence in new non-muscle-invasive bladder cancer: validation across time and place and recommendation for benchmarking. BJU Int 2012;109(11):1666–73.

5. Millan-Rodriguez F., Chechile-Toniolo G., Salvador-Bayarri J. et al. Primary superficial bladder cancer risk groups according to progression, mortality and recurrence. J Urol 2000;164 (3 Pt 1):680–4.

6. Sylvester R.J., van der Meijden A.P., Oosterlinck W. et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006;49(3):466–77.

7. Herr H.W., Sogani P.C. Does early cystectomy improve the survival of patients with high risk superficial bladder tumors? J Urol 2001;166(4):1296–9.

8. May M., Braun K.P., Richter W. et al. Radical cystectomy in the treatment of bladder cancer always in due time? Urologe A 2007;46(8):913–9.

9. Kilciler M., Bedir S., Erdemir F. et al. Comparison of ileal conduit and transureteroureterostomy with ureterocutaneostomy urinary diversion. Urol Int 2006;77(3):245–50.

10. Nieuwenhuijzen J.A., de Vries R.R., Bex A. et al. Urinary diversions after cystectomy: the association of clinical factors, complications and functional results of four different diversions. Eur Urol 2008;53(4): 834–44.

11. Neal D.E. Complications of ileal conduit diversion in adults with cancer followed up for at least five years. Br Med J (Clin Res Ed) 1985;290(6483):1695–7.

12. Benson M.C., Olsson C.A. Continent urinary diversion. Urol Clin North Am 1999;26(1):125–47, ix.

13. Hautmann R.E., Abol-Enein H., Hafez K. et al. Urinary diversion. Urology 2007;69 (1 Suppl):17–49.

14. Gemmill R., Sun V., Ferrell B. et al. Going with the flow: quality-of-life outcomes of cancer survivors with urinary diversion. J Wound Ostomy Continence Nurs 2010;37(1):65–72.


Review

For citations:


Reva I.А., Bormotin А.V., Prilepskaya Е.А., Kovylina М.V., Bernikov А.N., Tupikina N.V., Tsybulya О.A., Pushkar D.Yu. Choice of the optimal treatment strategy for patient with multifocal bladder cancer: clinical case. Cancer Urology. 2015;11(4):102-106. (In Russ.) https://doi.org/10.17650/1726-9776-2015-11-4-102-106

Views: 1207


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1726-9776 (Print)
ISSN 1996-1812 (Online)
X