Summary
The choice of surgical approach in the management of bladder cancer depends on the localisation, number, TNM-stage, histology and grade of malignancy of the tumors. The indications and possibilities of transurethral resection, laser and cryotherapy treatment will be discussed. At the moment TUR is the most common treatment for T1–2, No, Mo tumors but should always be carried out in association with mapping (multiple cold biopsies). The incidence of recurrences can probably be reduced by adjuvant intravesical cytotoxic therapy, especially in cases with multiple tumors, if cystectomy is not indicated or is not possible.
The indications and methods of open operative treatment are discussed. In all cases a pelvic lymphadenectomy should first be done for the purpose of staging. If a T3–4, No, Mo stage is confirmed, transvesical electroresection, partial bladder resection or cystectomy may be sufficient to cure the patient. If there is nodal involvement (category N+) lymphadenectomy and cystectomy leads to a reduction of tumor mass and prevents pain, but has to be followed by adjuvant treatment.
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References
H. -D. Adolphs, J. Thiele and W. Vahlensieck, Harnblasentumoren, Fortschr, Urol, Nephrol. Bd. 12, Steinkopff, Darmstadt, (1979).
A.F. Althausen, G.R. Prout Jr. and J.J. Daly, Non-invasive Papillary Carcinoma of the Bladder Associated with Carcinoma In Situ, J. Urol. 116: 575 (1976).
J.E. Altwein, T. Klotz and G.H. Jacobi, Stellenwert der Blasenteilresektion zur Therapie des Blasentumors, Akt. Urol. 11: 351 (1980).
J.E. Altwein, K.E. Kurth and R. Hohenfellner, Blasencarcinom: Therapeutisches Konzept der Urologischen Universitätsklinik Mainz, Urologe A, 16: 180 (1977).
R.E. Barnes, A.L. Dick, H.L. Hadley and O.L. Johnston, Survival Following Transurethral Resection of Bladder Carcinoma, Cancer Res. 37: 2895 (1977).
C.E. Blackard, D.B. Byar and VACURG, Results of a Clinical Trial of Surgery and Radiation in Stages II and III Carcinoma of the Bladder, J. Urol. 108: 875 (1972).
W.J. Catalona, Bladder Carcinoma, J. Urol. 123: 35 (1980).
R.C. Chan and D.E. Johnson, Integrated Therapy for Invasive Bladder Carcinoma. Experience with 108 Patients, Urology 12: 549 (1978).
P.B. Clark, Radical Cystectomy for Carcinoma of the Bladder, Brit. J. Urol. 50: 492 (1978).
E.D. Crawford and D.G. Skinner, Salvage Cystectomy After Irradiation Failure, J. Urol. 123: 32 (1980).
K.B. Cummings, J.T. Mason, R.J. Correa Jr. and R.P. Gibbons, Segmental Resection in the Management of Bladder Carcinoma, J. Urol. 119: 56 (1978).
J.D. Daughtry, L.P. Susan, B.H. Stewart and R.S. Straffon, Ileal Conduit and Cystectomy: a 10 Year Retrospective Study of Ileal Conduits Performed in Conjunction with Cystectomy and with a Minimum 5 Year Follow Up, J. Urol. 118: 556 (1977).
M.H. Faysal and F.S. Freiha, Evaluation of Partial Cystectomy for Carcinoma of Bladder, Urology 14: 352 (1979).
H.A. Gilbert, J.L. Logan, A.R. Kagan, H.A. Friedman, J.K. Cove, M. Fox, T.M. Muldoon, Y.W. Lonni, J.H. Rowe, J.F. Cooper, H. Nussbaum, P. Chan, A. Rao and A. Starr, The Natural History of Papillary Transitional Cell Carcinoma of the Bladder and its Treatment in an Unselected Population on the Basis of Histology Grading, J. Urol. 119: 488 (1978).
A. Hofstetter, E. Schmiedt and G. Staehler, Stellungnahme zur Arbeit von E. Matouschek, Urologe B 20: 25 (1980).
W. Mauermayer and R. Tauber, Die Tumoren der Harnblase — Indikation, Technik und Ergebnisse der Transurethralen Therapie, Urologe A 16: 185 (1977).
G.R. Prout Jr., The Surgical Management of Bladder Carcinoma, Urol. Clin. N. Amer. 3: 149 (1976).
G.R. Prout Jr., The Role of Surgery in the Potentially Curative Treatment of Bladder Carcinoma, Cancer Res. 37: 2764 (1977).
G.R. Prout Jr., P.P. Griffin and W.U. Shipley, Bladder Carcinoma as a Systemic Disease, Cancer 43: 2532 (1979).
T.W. Schoborg, J.L. Sapolsky and C.W. Lewis Jr., Carcinoma of Bladder Treated by Segmental Resection, J. Urol. 122: 473 (1979).
M.S. Soloway, W. Murphy, M.K. Rao and C. Cox, Serial Multiple- Site Biopsies in Patients with Bladder Cancer, J. Urol. 120: 57 (1978).
B. Van der Werf-Messing, Proceedings: Carcinoma of the Bladder Treated by Preoperative Irradiation Followed by Cystectomy, Cancer 32: 1084 (1973).
J. Vinnicombe and G.F. Abercrombie, Total Cystectomy — A Review, Brit. J. Urol. 50: 488 (1978).
W.F. Whitmore Jr., M.A. Batata, M.A. Ghoneim, H. Grabstald and A. Unal, Radical Cystectomy With or Without Prior Irradiation in the Treatment of Bladder Cancer, J. Urol. 118: 184 (1977).
J.L. Williams, J.C. Hammonds and N. Saunders, T1 Bladder Tumors, Brit. J. Urol. 49: 663 (1977).
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© 1982 Plenum Press, New York
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Vahlensieck, W. (1982). Bladder Cancer — Surgery. In: Denis, L., Smith, P.H., Pavone-Macaluso, M. (eds) Clinical Bladder Cancer. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3353-1_10
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DOI: https://doi.org/10.1007/978-1-4613-3353-1_10
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