SEOM Clinical Guideline for treatment of muscle-invasive and metastatic urothelial bladder cancer (2016)

The goal of this article is to provide recommendations for the diagnosis and treatment of muscle-invasive and metastatic bladder cancer. The diagnosis of muscle-invasive bladder cancer is made by pathologic evaluation after transurethral resection. Recently, a molecular classification has been propo...

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Detalles Bibliográficos
Autores: Lazaro, M, Gallardo, E, Domenech, M, Pinto, A, Gonzalez Del Alba, Aranzazu, Puente, J, Fernandez, O, Font, Albert, Lainez, N, Vazquez, S
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/20299
Acceso en línea:http://hdl.handle.net/20.500.12105/20299
Access Level:acceso abierto
Palabra clave:Bladder cancer
Cystectomy
Chemotherapy
Clinical guidelines
Guías de Práctica Clínica como Asunto
Humanos
Músculo Esquelético
Invasividad Neoplásica
Carcinoma de Células Transicionales
España
Neoplasias de la Vejiga Urinaria
Urinary Bladder Neoplasms
Spain
Muscle, Skeletal
Neoplasm Invasiveness
Humans
Carcinoma, Transitional Cell
Practice Guidelines as Topic
Descripción
Sumario:The goal of this article is to provide recommendations for the diagnosis and treatment of muscle-invasive and metastatic bladder cancer. The diagnosis of muscle-invasive bladder cancer is made by pathologic evaluation after transurethral resection. Recently, a molecular classification has been proposed. Staging of muscle-invasive bladder cancer must be done by computed tomography scans of the chest, abdomen and pelvis and classified on the basis of UICC system. Radical cystectomy and lymph node dissection are the treatment of choice. In muscle-invasive bladder cancer, neoadjuvant chemotherapy should be recommended in patients with good performance status and no renal function impairment. Although there is insufficient evidence for use of adjuvant chemotherapy, its use must be considered when neoadjuvant therapy had not been administered in high-risk patients. Multimodality bladder-preserving treatment in localized disease is an alternative in selected and compliant patients for whom cystectomy is not considered for clinical or personal reasons. In metastatic disease, the first-line treatment for patients must be based on cisplatin-containing combination. Vinflunine is the only drug approved for use in second line in Europe. Recently, immunotherapy treatment has demonstrated activity in this setting.