Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer
Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer
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DOI：
10.1016/j.eururo.2016.06.020
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发表时间：
2017-03-01
期刊：
影响因子：
23.4
通讯作者：
Ribal, Maria J.
中科院分区：
文献类型：
--
作者：
Witjes, J. Alfred;Lebret, Thierry;Ribal, Maria J.
背景：浸润性膀胱癌是一种常见的疾病，尽管有最佳的治疗，死亡率仍很高。欧洲泌尿外科协会（EAU）肌肉浸润性和转移性膀胱癌（MIBC）指南每年更新，并提供信息，以优化诊断，治疗和随访这一患者population.Objective：提供一个总结的EAU指南的医生和患者面临的肌肉浸润性和转移性膀胱癌。证据采集：一个由膀胱癌专家组成的国际多学科小组审查并讨论了对涵盖指南所有部分的几个数据库进行全面文献检索的结果。专家组根据已建立的分类系统定义了证据等级和推荐等级。证据综合：讨论了膀胱癌的流行病学和病因学。适当的诊断途径，包括病理和成像的要求，概述。几种治疗方案，包括膀胱保留治疗和治疗方式（不同形式的手术，放射治疗和化疗）的组合进行了描述。这些模式的顺序进行了讨论。潜在的适应症和禁忌症，如合并症，与治疗选择有关。有一个新的段落是关于男性和女性的器官保留方法，以及微创手术。建议化疗在适合和不适合的患者，包括二线选择。最后，一个后续的时间表provided.Conclusions：目前的EAU肌肉浸润性和转移性膀胱癌指南的摘要提供了一个最新的概述，现有的文献和证据处理的诊断，治疗和随访的患者转移性和肌肉浸润性膀胱cancer.Patient摘要：膀胱癌是一个重要的疾病，死亡率高。这些更新的指南帮助临床医生完善诊断，并为转移性和肌肉浸润性膀胱癌患者选择适当的治疗和随访。(C)2016年欧洲泌尿外科协会。Elsevier B.V.出版，保留所有权利。
Context: Invasive bladder cancer is a frequently occurring disease with a high mortality rate despite optimal treatment. The European Association of Urology (EAU) Muscle-invasive and Metastatic Bladder Cancer (MIBC) Guidelines are updated yearly and provides information to optimise diagnosis, treatment, and follow-up of this patient population.Objective: To provide a summary of the EAU guidelines for physicians and patients confronted with muscle-invasive and metastatic bladder cancer.Evidence acquisition: An international multidisciplinary panel of bladder cancer experts reviewed and discussed the results of a comprehensive literature search of several databases covering all sections of the guidelines. The panel defined levels of evidence and grades of recommendation according to an established classification system.Evidence synthesis: Epidemiology and aetiology of bladder cancer are discussed. The proper diagnostic pathway, including demands for pathology and imaging, is outlined. Several treatment options, including bladder-sparing treatments and combinations of treatment modalities (different forms of surgery, radiation therapy, and chemotherapy) are described. Sequencing of these modalities is discussed. Potential indications and contraindications, such as comorbidity, are related to treatment choice. There is a new paragraph on organ-sparing approaches, both in men and in women, and on minimal invasive surgery. Recommendations for chemotherapy in fit and unfit patients are provided including second-line options. Finally, a follow-up schedule is provided.Conclusions: The current summary of the EAU Muscle-invasive and Metastatic Bladder Cancer Guidelines provides an up-to-date overview of the available literature and evidence dealing with diagnosis, treatment, and follow-up of patients with metastatic and muscleinvasive bladder cancer.Patient summary: Bladder cancer is an important disease with a high mortality rate. These updated guidelines help clinicians refine the diagnosis and select the appropriate therapy and follow-up for patients with metastatic and muscle-invasive bladder cancer. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.