Partial cystectomy is a surgical bladder-sparing option for selected patients with muscle-invasive bladder cancer (MIBC), urachal adenocarcinoma and diverticular bladder tumors. Partial cystectomy hold several advantages. It allows for definite pathology and accurate staging while avoiding side effects from radiation therapy and preserves the option for salvage radical therapy (radical cystectomy or radical radiotherapy). Patients should have a CT urogram, prostatic urethral biopsy and mapping biopsies or blue light cystoscopy to rule out multifocal disease or CIS. Small solitary MIBC patients without carcinoma in situ in an area of the bladder where resection can be performed with negative margin would be the ideal candidates for partial cystectomy. Neoadjuvant systemic therapy is recommended for patients undergoing partial cystectomy. Partial cystectomy can be performed either by open or robotic approaches. When compared to radical cystectomy, partial cystectomy affords a lower complication rate and length of stay and better quality of life. Recurrence-free survival, cancer-specific survival and overall survival at 5 years is 39–67%, 62–84% and 45–70%, respectively. Following partial cystectomy, patients should have three monthly cystoscopy and urinary cytology for the first 24 months followed by 6-monthly cystoscopy for year 3 and 4 and then yearly for life. Cross-sectional imaging should be performed every 3–6 months for the first 2–3 years and then annually for 5 years.
膀胱部分切除术是针对特定肌层浸润性膀胱癌、脐尿管腺癌及膀胱憩室肿瘤患者的一种保留膀胱的手术选择。该术式具有多重优势：既能获取明确病理诊断和准确分期，又可避免放疗相关副作用，同时为后续根治性挽救治疗（根治性膀胱切除术或根治性放疗）保留选择空间。术前患者需接受CT尿路造影、前列腺尿道活检及多点活检或蓝光膀胱镜检查，以排除多灶性病变或原位癌。膀胱部分切除术的理想适应人群为：单发小体积肌层浸润性膀胱癌、不伴原位癌、且肿瘤位于可保证切缘阴性切除的膀胱区域。推荐接受膀胱部分切除术的患者进行新辅助全身治疗。手术可通过开放或机器人辅助方式实施。与根治性膀胱切除术相比，膀胱部分切除术并发症发生率更低、住院时间更短、生活质量更优。其5年无复发生存率、癌症特异性生存率及总生存率分别为39-67%、62-84%和45-70%。术后随访方案：前24个月每3个月行膀胱镜检及尿细胞学检查，第3-4年每6个月膀胱镜检，此后终身每年复查；前2-3年每3-6个月进行横断面影像学检查，随后5年内每年复查一次。
肿瘤(癌症)患者之家