Zusammenfassung
Bei der Nachsorge des Blasenkarzinoms muss klar zwischen den oberflächlichen und muskelinvasiven bzw. metastasierten Tumoren unterschieden werden. Beim oberflächlichen Blasenkarzinom konnte bislang kein nicht-invasives Verfahren die Urethrozystoskopie ersetzen. Die Nachsorgeintervalle richten sich hier nach der Risikoklassifikation. Auch primär in sano operierte muskelinvasive Tumoren metastasieren zu einem Drittel im Verlauf. Diese wie auch die primär metastasierten Tumoren können nur palliativ behandelt werden, daher kann man hier nicht von Nachsorge, sondern eher von Therapiekontrolle sprechen. Nichtsdestotrotz wird in der aktuellen S3-Leitlinie auch zum fortgeschrittenen Blasenkarzinom eine regelmäßige Nachsorge empfohlen, da sich mit den neuen Therapieoptionen das Überleben der Patienten deutlich verbessert hat. Nicht zu vergessen ist die Kontrolle möglicher Komplikationen nach den verschiedenen Formen der Harnableitung.
Abstract
Concerning follow-up in bladder cancer, it must be distinguished between superficial, muscle-invasive, and metastatic tumors. In superficial bladder cancer, urethrocystoscopy is still standard for follow-up. Frequency depends on the risk classification. Even muscle-invasive carcinomas, which underwent a R0 resection, will metastasize in about 30% of cases. These tumors as well as primarily metastasized cancer cannot be cured. Therefore, in these cases, one should not speak about follow-up but therapeutic control. Nonetheless, even in these cases the S3 guideline recommends regular follow-up examinations because new therapeutic options can clearly improve patient survival. Possible complications of urinary diversions need consideration during follow-up.
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Zraik, I., Krege, S. Nachsorge des oberflächlichen und metastasierten Blasenkarzinoms. Urologe 61, 477–483 (2022). https://doi.org/10.1007/s00120-022-01813-8
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DOI: https://doi.org/10.1007/s00120-022-01813-8