Role of surgical consolidation in metastatic urothelial carcinoma.
Role of surgical consolidation in metastatic urothelial carcinoma.
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DOI：
10.1097/mou.0000000000000329
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发表时间：
2016-11
影响因子：
2.5
通讯作者：
Shinohara N
中科院分区：
文献类型：
--
作者：
Abe T;Matsumoto R;Shinohara N
自全身性联合化疗发展以来，化疗后切除主要用于局部晚期和/或最初无法切除的膀胱癌患者，并且在非常精选的患者中，也进行了内脏转移的手术巩固。本文的目的是回顾和总结目前的证据，手术巩固在转移性尿路上皮癌中的作用。转移瘤切除术的作用尚未在随机环境中进行检验。对于局部晚期和/或淋巴结阳性膀胱癌，研究进一步支持手术巩固的益处，特别是在对全身化疗反应良好的情况下。关于内脏转移的转移切除术，最近的证据表明肺转移（理想的小孤立病灶）是一个很好的指示。对化疗反应良好，淋巴结/肺部病变有限，身体状况良好的患者是手术巩固的好候选人。仔细选择病人是必须的。
Since the development of systemic combination chemotherapy, postchemotherapy extirpation has been performed in selected patients mainly with locally advanced and/or initially unresectable bladder cancer, and, in very selected patients, surgical consolidation for visceral metastases has also been performed. The purpose of this article was to review and summarize the current evidence for the role of surgical consolidation in metastatic urothelial carcinoma. The role of metastasectomy has not yet been examined in a randomized setting. In terms of locally advanced and/or node-positive bladder cancer, studies further support the benefit of surgical consolidation, especially after a favorable response to systemic chemotherapy. Regarding metastasectomy for visceral metastasis, recent evidence suggested that lung metastases (ideally small solitary lesions) are a good indication. Patients with a good response to chemotherapy, limited nodal/pulmonary disease, and a favorable performance status are good candidates for surgical consolidation. Careful patient selection is mandatory.