Advertisement

Der Urologe

, Volume 57, Issue 6, pp 693–701 | Cite as

Tumornachsorge des Harnblasenkarzinoms

Die richtigen Untersuchungen zum richtigen Zeitpunkt
  • P. Olbert
  • P. J. Goebell
  • A. Hegele
Leitthema
  • 181 Downloads

Zusammenfassung

Die Vorgaben zur Nachsorge des Harnblasenkarzinoms beruhen großteils auf Studien mit niedrigem Evidenzgrad und den daraus resultierenden, zumeist auf Expertenkonsens basierenden Empfehlungen der Leitlinien. Die Nachsorge des nicht-muskelinvasiven Harnblasenkarzinoms stützt sich auf Zystoskopie, Zytologie und in begrenztem Maße auf bildgebende Untersuchungen. Die Nachsorge des muskelinvasiven Urothelkarzinoms der Harnblase hängt in erster Linie von dem gewählten Therapieverfahren und vom Erkrankungsstadium ab. Die Nachsorge wird hier außerdem ergänzt durch funktionelle und die Lebensqualität betreffende Aspekte. Dies gilt in noch höherem Maße auch für die Gestaltung der Tumornachsorge in der Palliativsituation. Hier stehen individuell angepasst die Untersuchungen im Vordergrund, aus denen Konsequenzen für Lebensverlängerung und Symptomlinderung ableitbar sind.

Schlüsselwörter

Urothelkarzinom Harnblase Zytoskopie Zystektomie Radiochemotherapie 

Follow-up of bladder cancer

The right examinations at the right time

Abstract

Schedules for the follow-up (FU) of bladder cancer patients are predominantly based on studies with low level of evidence and the resulting guidelines’ recommendations that are often founded on expert consensus. FU of non-muscle invasive bladder cancer (NMIBC) includes cystoscopy and cytology as standard, and imaging modalities to a lower extent. FU of muscle-invasive bladder cancer (MIBC) depends primarily on the therapeutic modality chosen and on the stage of disease. In this scenario, FU is complemented by functional and quality of life related aspects. These apply even more for FU in palliative situations. Here, the individual focus is on examinations that might have a consequence in terms of survival and/or symptom relief.

Keywords

Urothelial carcinoma Urinary bladder Cystoscopy Cystectomy Chemoradiotherapy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

P. Olbert, P. J. Goebell und A. Hegele geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L et al (2006) 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 49(3):466–465 (discussion 75–7)CrossRefPubMedGoogle Scholar
  2. 2.
    Leitlinienprogramm Onkologie der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF) DKeVDuDKD. S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Harnblasenkarzinoms Langversion 1.1 – November 2016 AWMF-Registernummer: 032/038OL 2016. http://www.awmf.org/uploads/tx_szleitlinien/032-038ol_l_S3_Harnblasenkarzinom_2016-12.pdf. Zugegriffen: 15.03.2018
  3. 3.
    Altieri VM, Castellucci R, Palumbo P, Verratti V, Sut M, Olivieri R et al (2012) Recurrence and progression in non-muscle-invasive bladder cancer using EORTC risk tables. Urol Int 89(1):61–66CrossRefPubMedGoogle Scholar
  4. 4.
    Fernandez-Gomez J, Madero R, Solsona E, Unda M, Martinez-Pineiro L, Ojea A et al (2011) The EORTC tables overestimate the risk of recurrence and progression in patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Guerin: external validation of the EORTC risk tables. Eur Urol 60(3):423–430CrossRefPubMedGoogle Scholar
  5. 5.
    Lammers RJ, Palou J, Witjes WP, Janzing-Pastors MH, Caris CT, Witjes JA (2014) Comparison of expected treatment outcomes, obtained using risk models and international guidelines, with observed treatment outcomes in a Dutch cohort of patients with non-muscle-invasive bladder cancer treated with intravesical chemotherapy. BJU Int 114(2):193–201CrossRefPubMedGoogle Scholar
  6. 6.
    Holmang S, Johansson SL (2002) Stage Ta-T1 bladder cancer: the relationship between findings at first followup cystoscopy and subsequent recurrence and progression. J Urol 167(4):1634–1637CrossRefPubMedGoogle Scholar
  7. 7.
    Olsen LH, Genster HG (1995) Prolonging follow-up intervals for non-invasive bladder tumors: a randomized controlled trial. Scand J Urol Nephrol Suppl 172:33–36PubMedGoogle Scholar
  8. 8.
    Mariappan P, Smith G (2005) A surveillance schedule for G1Ta bladder cancer allowing efficient use of check cystoscopy and safe discharge at 5 years based on a 25-year prospective database. J Urol 173(4):1108–1111CrossRefPubMedGoogle Scholar
  9. 9.
    Zieger K, Wolf H, Olsen PR, Hojgaard K (2000) Long-term follow-up of noninvasive bladder tumours (stage Ta): recurrence and progression. BJU Int 85(7):824–828CrossRefPubMedGoogle Scholar
  10. 10.
    Leblanc B, Duclos AJ, Benard F, Cote J, Valiquette L, Paquin JM et al (1999) Long-term followup of initial Ta grade 1 transitional cell carcinoma of the bladder. J Urol 162(6):1946–1950CrossRefPubMedGoogle Scholar
  11. 11.
    Holmang S, Strock V (2012) Should follow-up cystoscopy in bacillus Calmette-Guerin-treated patients continue after five tumour-free years? Eur Urol 61(3):503–507CrossRefPubMedGoogle Scholar
  12. 12.
    Soloway MS, Bruck DS, Kim SS (2003) Expectant management of small, recurrent, noninvasive papillary bladder tumors. J Urol 170(2 Pt 1):438–441CrossRefPubMedGoogle Scholar
  13. 13.
    Messing EM, Teot L, Korman H, Underhill E, Barker E, Stork B et al (2005) Performance of urine test in patients monitored for recurrence of bladder cancer: a multicenter study in the United States. J Urol 174(4 Pt 1):1238–1241CrossRefPubMedGoogle Scholar
  14. 14.
    Comploj E, Mian C, Ambrosini-Spaltro A, Dechet C, Palermo S, Trenti E et al (2013) uCyt+/ImmunoCyt and cytology in the detection of urothelial carcinoma: an update on 7422 analyses. Cancer Cytopathol 121(7):392–397CrossRefPubMedGoogle Scholar
  15. 15.
    Kamat AM, Karam JA, Grossman HB, Kader AK, Munsell M, Dinney CP (2011) Prospective trial to identify optimal bladder cancer surveillance protocol: reducing costs while maximizing sensitivity. BJU Int 108(7):1119–1123CrossRefPubMedGoogle Scholar
  16. 16.
    Palou J, Rodriguez-Rubio F, Huguet J, Segarra J, Ribal MJ, Alcaraz A et al (2005) Multivariate analysis of clinical parameters of synchronous primary superficial bladder cancer and upper urinary tract tumor. J Urol 174(3):859–861 (discussion 61)CrossRefPubMedGoogle Scholar
  17. 17.
    Canales BK, Anderson JK, Premoli J, Slaton JW (2006) Risk factors for upper tract recurrence in patients undergoing long-term surveillance for stage ta bladder cancer. J Urol 175(1):74–77CrossRefPubMedGoogle Scholar
  18. 18.
    Van Der Molen AJ, Cowan NC, Mueller-Lisse UG, Nolte-Ernsting CC, Takahashi S, Cohan RH et al (2008) CT urography: definition, indications and techniques. A guideline for clinical practice. Eur Radiol 18(1):4–17CrossRefPubMedGoogle Scholar
  19. 19.
    Donat SM (2006) Staged based directed surveillance of invasive bladder cancer following radical cystectomy: valuable and effective? World J Urol 24(5):557–564CrossRefPubMedGoogle Scholar
  20. 20.
    Ghoneim MA, Abol-Enein H (2008) Management of muscle-invasive bladder cancer: an update. Nat Clin Pract Urol 5(9):501–508CrossRefPubMedGoogle Scholar
  21. 21.
    Bochner BH, Montie JE, Lee CT (2003) Follow-up strategies and management of recurrence in urologic oncology bladder cancer: invasive bladder cancer. Urol Clin North Am 30(4):777–789CrossRefPubMedGoogle Scholar
  22. 22.
    Vrooman OP, Witjes JA (2010) Follow-up of patients after curative bladder cancer treatment: guidelines vs. practice. Curr Opin Urol 20(5):437–442CrossRefPubMedGoogle Scholar
  23. 23.
    Gakis G, Black PC, Bochner BH, Boorjian SA, Stenzl A, Thalmann GN et al (2017) Systematic review on the fate of the remnant Urothelium after radical cystectomy. Eur Urol 71(4):545–557CrossRefPubMedGoogle Scholar
  24. 24.
    Huguet J (2013) Follow-up after radical cystectomy based on patterns of tumour recurrence and its risk factors. Actas Urol Esp 37(6):376–382CrossRefPubMedGoogle Scholar
  25. 25.
    Picozzi S, Ricci C, Gaeta M, Ratti D, Macchi A, Casellato S et al (2012) Upper urinary tract recurrence following radical cystectomy for bladder cancer: a meta-analysis on 13,185 patients. J Urol 188(6):2046–2054CrossRefPubMedGoogle Scholar
  26. 26.
    Freeman JA, Tarter TA, Esrig D, Stein JP, Elmajian DA, Chen SC et al (1996) Urethral recurrence in patients with orthotopic ileal neobladders. J Urol 156(5):1615–1619CrossRefPubMedGoogle Scholar
  27. 27.
    Nieder AM, Sved PD, Gomez P, Kim SS, Manoharan M, Soloway MS (2004) Urethral recurrence after cystoprostatectomy: implications for urinary diversion and monitoring. Urology 64(5):950–954CrossRefPubMedGoogle Scholar
  28. 28.
    Cho KS, Seo JW, Park SJ, Lee YH, Choi YD, Cho NH et al (2009) The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder. Urol Int 82(3):306–311CrossRefPubMedGoogle Scholar
  29. 29.
    Lu YY, Chen JH, Liang JA, Wang HY, Lin CC, Lin WY et al (2012) Clinical value of FDG PET or PET/CT in urinary bladder cancer: a systemic review and meta-analysis. Eur J Radiol 81(9):2411–2416CrossRefPubMedGoogle Scholar
  30. 30.
    Fernandez MI, Parikh S, Grossman HB, Katz R, Matin SF, Dinney CP et al (2012) The role of FISH and cytology in upper urinary tract surveillance after radical cystectomy for bladder cancer. Urol Oncol 30(6):821–824CrossRefPubMedGoogle Scholar
  31. 31.
    Soukup V, Babjuk M, Bellmunt J, Dalbagni G, Giannarini G, Hakenberg OW et al (2012) Follow-up after surgical treatment of bladder cancer: a critical analysis of the literature. Eur Urol 62(2):290–302CrossRefPubMedGoogle Scholar
  32. 32.
    Madersbacher S, Schmidt J, Eberle JM, Thoeny HC, Burkhard F, Hochreiter W et al (2003) Long-term outcome of ileal conduit diversion. J Urol 169(3):985–990CrossRefPubMedGoogle Scholar
  33. 33.
    Kalble T, Hofmann I, Thuroff JW, Stein R, Hautmann R, Riedmiller H et al (2012) Secondary malignancies in urinary diversions. Urologe A 51(4):500–502-6CrossRefPubMedGoogle Scholar
  34. 34.
    Duerksen DR, Fallows G, Bernstein CN (2006) Vitamin B12 malabsorption in patients with limited ileal resection. Nutrition 22(11–12):1210–1213CrossRefPubMedGoogle Scholar
  35. 35.
    Mills RD, Studer UE (1999) Metabolic consequences of continent urinary diversion. J Urol 161(4):1057–1066CrossRefPubMedGoogle Scholar
  36. 36.
    Pattni S, Walters JR (2009) Recent advances in the understanding of bile acid malabsorption. Br Med Bull 92:79–93CrossRefPubMedGoogle Scholar
  37. 37.
    Sapre N, Anderson P, Foroudi F (2012) Management of local recurrences in the irradiated bladder: a systematic review. BJU Int 110(Suppl 4):51–57CrossRefPubMedGoogle Scholar
  38. 38.
    Zietman AL, Grocela J, Zehr E, Kaufman DS, Young RH, Althausen AF et al (2001) Selective bladder conservation using transurethral resection, chemotherapy, and radiation: management and consequences of Ta, T1, and Tis recurrence within the retained bladder. Urology 58(3):380–385CrossRefPubMedGoogle Scholar
  39. 39.
    Weiss C, Wittlinger M, Engehausen DG, Krause FS, Ott OJ, Dunst J et al (2008) Management of superficial recurrences in an irradiated bladder after combined-modality organ-preserving therapy. Int J Radiat Oncol Biol Phys 70(5):1502–1506CrossRefPubMedGoogle Scholar
  40. 40.
    Chung PW, Bristow RG, Milosevic MF, Yi QL, Jewett MA, Warde PR et al (2007) Long-term outcome of radiation-based conservation therapy for invasive bladder cancer. Urol Oncol 25(4):303–309CrossRefPubMedGoogle Scholar
  41. 41.
    Gamal El-Deen H, Elshazly HF, Zeina AEA (2009) Clinical experience with radiotherapy alone and radiochemotherapy with platin based regimens in organ-sparing treatment of invasive bladder cancer. J Egypt Natl Canc Inst 21(1):59–70PubMedGoogle Scholar
  42. 42.
    Perdona S, Autorino R, Damiano R, De Sio M, Morrica B, Gallo L et al (2008) Bladder-sparing, combined-modality approach for muscle-invasive bladder cancer: a multi-institutional, long-term experience. Cancer 112(1):75–83CrossRefPubMedGoogle Scholar
  43. 43.
    Weiss C, Engehausen DG, Krause FS, Papadopoulos T, Dunst J, Sauer R et al (2007) Radiochemotherapy with cisplatin and 5‑fluorouracil after transurethral surgery in patients with bladder cancer. Int J Radiat Oncol Biol Phys 68(4):1072–1080CrossRefPubMedGoogle Scholar
  44. 44.
    Sabaa MA, El-Gamal OM, Abo-Elenen M, Khanam A (2010) Combined modality treatment with bladder preservation for muscle invasive bladder cancer. Urol Oncol 28(1):14–20CrossRefPubMedGoogle Scholar
  45. 45.
    Zapatero A, de Vidales MC, Arellano R, Bocardo G, Perez M, Rios P (2010) Updated results of bladder-sparing trimodality approach for invasive bladder cancer. Urol Oncol 28(4):368–374CrossRefPubMedGoogle Scholar
  46. 46.
    George L, Bladou F, Bardou VJ, Gravis G, Tallet A, Alzieu C et al (2004) Clinical outcome in patients with locally advanced bladder carcinoma treated with conservative multimodality therapy. Urology 64(3):488–493CrossRefPubMedGoogle Scholar
  47. 47.
    Arias F, Dominguez MA, Martinez E, Illarramendi JJ, Miquelez S, Pascual I et al (2000) Chemoradiotherapy for muscle invading bladder carcinoma. Final report of a single institutional organ-sparing program. Int J Radiat Oncol Biol Phys 47(2):373–378CrossRefPubMedGoogle Scholar
  48. 48.
    Aboziada MA, Hamza HM, Abdlrahem AM (2009) Initial results of bladder preserving approach by chemo-radiotherapy in patients with muscle invading transitional cell carcinoma. J Egypt Natl Canc Inst 21(2):167–174PubMedGoogle Scholar
  49. 49.
    Peyromaure M (2004) Simultaneous radio-chemotherapy: is it an alternative for cystectomy? Prog Urol 14(1 Suppl):11–13PubMedGoogle Scholar
  50. 50.
    Serretta V, Lo Greco G, Pavone C, Pavone-Macaluso M (1998) The fate of patients with locally advanced bladder cancer treated conservatively with neoadjuvant chemotherapy, extensive transurethral resection and radiotherapy: 10-year experience. J Urol 159(4):1187–1191CrossRefPubMedGoogle Scholar
  51. 51.
    Ikushima H, Iwamoto S, Osaki K, Furutani S, Yamashita K, Kawanaka T et al (2008) Effective bladder preservation strategy with low-dose radiation therapy and concurrent intraarterial chemotherapy for muscle-invasive bladder cancer. Radiat Med 26(3):156–163CrossRefPubMedGoogle Scholar
  52. 52.
    Caffo O, Fellin G, Graffer U, Mussari S, Tomio L, Galligioni E (2011) Gemcitabine and radiotherapy plus cisplatin after transurethral resection as conservative treatment for infiltrating bladder cancer: Long-term cumulative results of 2 prospective single-institution studies. Cancer 117(6):1190–1196CrossRefPubMedGoogle Scholar
  53. 53.
    Oh KS, Soto DE, Smith DC, Montie JE, Lee CT, Sandler HM (2009) Combined-modality therapy with gemcitabine and radiation therapy as a bladder preservation strategy: long-term results of a phase I trial. Int J Radiat Oncol Biol Phys 74(2):511–517CrossRefPubMedGoogle Scholar
  54. 54.
    Joung JY, Han KS, Kim TS, Seo HK, Chung J, Lee KH (2008) Single institutional experience of bladder-preserving trimodality treatment for muscle-invasive bladder cancer. J Korean Med Sci 23(4):598–603CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Mohammed A, Hameed A, Shergill I, Barua J (2011) The practice of the first check cystoscopy following radiotherapy for the treatment of muscle-invasive (T3N0M0) bladder cancer: a UK national survey. Int Urol Nephrol 43(2):377–381CrossRefPubMedGoogle Scholar
  56. 56.
    Gravis G, Fizazi K, Joly F, Oudard S, Priou F, Esterni B et al (2013) Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol 14(2):149–158CrossRefPubMedGoogle Scholar
  57. 57.
    Hassan JM, Cookson MS, Smith JA Jr., Chang SS (2006) Patterns of initial transitional cell recurrence in patients after cystectomy. J Urol 175(6):2054–2057CrossRefPubMedGoogle Scholar
  58. 58.
    Eisenberg MS, Thompson RH, Frank I, Kim SP, Cotter KJ, Tollefson MK et al (2014) Long-term renal function outcomes after radical cystectomy. J Urol 191(3):619–625CrossRefPubMedGoogle Scholar
  59. 59.
    Shimko MS, Tollefson MK, Umbreit EC, Farmer SA, Blute ML, Frank I (2011) Long-term complications of conduit urinary diversion. J Urol 185(2):562–567CrossRefPubMedGoogle Scholar
  60. 60.
    Hautmann RE, de Petriconi RC, Volkmer BG (2011) 25 years of experience with 1,000 neobladders: long-term complications. J Urol 185(6):2207–2212CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Praxis und Belegabteilung für Urologie und AndrologieBrixsana Private ClinicBrixenItalien
  2. 2.Urologische und Kinderurologische KlinikFriedrich-Alexander UniversitätErlangenDeutschland
  3. 3.Klinik für Urologie und KinderurologieUniversitätsklinikum Marburg UKGMMarburgDeutschland

Personalised recommendations