Bladder cancer clinical guidelines panel summary report on the management of nonmuscle invasive bladder cancer (stages Ta, T1 and TIS)
Bladder cancer clinical guidelines panel summary report on the management of nonmuscle invasive bladder cancer (stages Ta, T1 and TIS)
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DOI：
10.1016/s0022-5347(05)68208-0
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发表时间：
1999-11-01
影响因子：
6.6
通讯作者：
Rowland, RG
中科院分区：
文献类型：
--
作者：
Smith, JA;Labasky, RF;Rowland, RG
目的：美国泌尿外科协会召开的膀胱癌临床指南小组分析文献有关的方法治疗非肌层浸润性膀胱癌，并提出实践政策的建议，主要是基于治疗outcomes data.Materials和Methods：该小组检索了MEDLINE数据库的所有文章相关的非肌层浸润性膀胱癌1966年至1998年1月出版。结果数据提取后接受的文章进行小组审查和荟萃分析，以产生比较概率估计替代treatment.Results：所有的膀胱内药物（塞替派，卡介苗，丝裂霉素C和阿霉素）作为辅助治疗经尿道切除术后，导致复发的概率较低相比，单独切除术。然而，没有证据表明，膀胱内治疗影响长期progress.Conclusions：对于没有先前膀胱内治疗的患者，辅助膀胱内化疗或免疫治疗是内镜下切除低级别Ta膀胱癌后的治疗选择。膀胱内灌注卡介苗或丝裂霉素C建议原位癌，并在内镜下切除T1和高级别Ta肿瘤。
Purpose: The American Urological Association convened the Bladder Cancer Clinical Guidelines Panel to analyze the literature regarding available methods of treating nonmuscle invasive bladder cancer, and to make practice policy recommendations based primarily on treatment outcomes data.Materials and Methods: The panel searched the MEDLINE database for all articles related to nonmuscle invasive bladder cancer published from 1966 to January 1998. Outcomes data were extracted from articles accepted after panel review and meta-analyzed to produce comparative probability estimates for alternative treatments.Results: All of the intravesical agents (thiotepa, bacillus Calmette-Guerin, mitomycin C and doxorubicin) when used as adjuvant therapy after transurethral resection resulted in a lower probability of recurrence compared to resection alone. However, there is no evidence that intravesical therapy affects long-term progression.Conclusions: For patients with no prior intravesical therapy adjuvant intravesical chemotherapy or immunotherapy is a treatment option after endoscopic removal of low grade Ta bladder cancers. Intravesical instillation of bacillus Calmette-Guerin or mitomycin C is recommended for carcinoma in situ, and after endoscopic removal of T1 and high grade Ta tumors.