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...
| Autores: | , , , , , , , , , |
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| 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 |
| 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. |
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