Recent advances in the diagnosis and treatment of bladder cancer

BMC Medicine

Muhammad S Khan¹  Prokar Dasgupta²  Michele Billia¹  Arun Sahai¹  Grace Cheung¹ 

[1] Urology Centre, Guy's Hospital, Guy's and St Thomas' NHS Trust, London, SE1 9RT, UK;Medical Research Council (MRC) Centre for Transplantation, King's College London, King's Health Partners, Guy's Hospital, London, SE1 9RT, UK

关键词: urinary markers;    radical cystectomy;    photodynamic diagnosis;    narrow-band imaging;    cystoscopy;    bladder cancer;   

Others  :  857223
DOI  :  10.1186/1741-7015-11-13

 received in 2012-05-16, accepted in 2013-01-17,  发布年份 2013

【 摘 要 】

Bladder cancer is the commonest malignancy of the urinary tract. In this review, we look at the latest developments in the diagnosis and management of this condition. Cystoscopy and urine cytology are the most important tools in the diagnosis and follow-up of bladder cancer. Various alternatives have been investigated, either to reduce the frequency of cystoscopy, or improve its sensitivity for detection of tumors. These include urine-based markers and point-of-care tests. Narrow-band imaging and photodynamic diagnosis/blue-light cystoscopy have shown promise in improving detection and reducing recurrence of bladder tumors, by improving the completion of bladder resection when compared with standard resection in white light. The majority of patients with a new diagnosis of bladder cancer have non-muscle-invasive bladder cancer, which requires adjuvant intravesical chemotherapy and/or immunotherapy. Recent developments in post-resection intravesical regimens are discussed. For patients with muscle-invasive bladder cancer, both laparoscopic radical cystectomy and robot-assisted radical cystectomy have been shown to reduce peri-operative morbidity, while being oncologically equivalent to open radical cystectomy in the medium term. Bladder-preserving strategies entail resection and chemoradiation, and in selected patients give equivalent results to surgery. The development, advantages, and disadvantages of these newer approaches are also discussed.

【 授权许可】

   
2013 Cheung et al; licensee BioMed Central Ltd.

【 图 表 】

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