Radical cystectomy with lymph node dissection and urinary diversion is the gold-standard treatment for non-metastatic muscle-invasive bladder cancer (MIBC). However, in patients who refuse cystectomy, or in whom cystectomy carries a high risk, bladder-preserving therapies remain potential options. Bladder preservation therapies can include maximal debulking transurethral resection of bladder tumor (TURBT), concurrent chemoradiation therapy, followed by cystoscopy to assess response. At this time, maximal TURBT is recommended for patients prior to the initiation of chemoradiation therapy or in patients with residual bladder tumors after the completion of chemoradiation therapy. That being said, TURBT carries significant risks such as bladder perforation, bleeding, and infection, ultimately risking delayed systemic treatment. Hence, understanding its role within trimodal therapy is crucial to avoid undue suffering in patients. Herein, we review the current literature on the impact of debulking TURBT in non-metastatic MIBC.
根治性膀胱切除术联合淋巴结清扫及尿流改道术是非转移性肌层浸润性膀胱癌（MIBC）的标准治疗方案。然而，对于拒绝接受膀胱切除术或手术风险较高的患者，保留膀胱的治疗方法仍是潜在选择。保留膀胱治疗可包括最大程度的经尿道膀胱肿瘤切除术（TURBT）、同步放化疗，随后通过膀胱镜检查评估疗效。目前，建议患者在开始放化疗前或完成放化疗后仍有膀胱残留肿瘤时接受最大程度的TURBT。但需注意，TURBT存在膀胱穿孔、出血和感染等显著风险，可能最终导致全身治疗延迟。因此，明确其在三联疗法中的作用对于避免患者承受不必要的痛苦至关重要。本文综述了当前关于减瘤性TURBT在非转移性MIBC中作用的文献。
肿瘤(癌症)患者之家