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Blasenkrebs — Aktuelles zu Ätiologie, Diagnostik und Therapie

  • Folker Domnitz
  • Stefanie Uibel
  • David A. Groneberg
Originalarbeit / Original Article
  • 52 Downloads

Zusammenfassung

Blasenkrebs ist eine auch in den Industrieländern immer noch häufige Erkrankung. In der Ätiologie steht neben konsum-bedingten Faktoren eine berufliche Exposition gegenüber einer Vielzahl von Schadstoffen im Vordergrund. Durch lange Latenzzeiten können sich hier weit zurückliegende Belastungen manifestieren. Daher ist die arbeitsmedizinische Bedeutung der Erkrankung immer noch sehr groß. Etwa 90 Prozent der Blasenkrebserkrankungen liegt ein Urothelkarzinom zugrunde. Häufigstes Erstsymptom des Harnblasenkrebses ist eine schmerzlose Hämaturie. Auch dysurische Beschwerden sowie rezidivierende Harnwegsinfekte können Symptome eines Harnblasenkarzinoms sein. Goldstandard der Diagnostik ist die Urethrozystoskopie, Tumormarker und Urinzytologie sind weitere wichtige Bestandteile der Diagnostik. Bei Erstdiagnose sind ca. 80 Prozent der Urothelkarzinome nicht muskelinvasiv. Nach initialer transurethraler Resektion erfolgt die histopathologische Einordnung des Tumorgeschehens, die über das weitere therapeutische Vorgehen entscheidet. Nicht muskelinvasive Tumoren werden in der Regel einer Nachresektion sowie gegebenenfalls einer adjuvanten intravesikalen Chemotherapie zugeführt. Für Patienten mit Muskelinvasion stellt die Zystektomie die Therapie der Wahl dar, bei fortgeschrittener Erkrankung kommen zumeist Cisplatinbasierte Chemotherapieprotokolle zum Einsatz.

Schlüsselwörter

Harnblase Blasenkrebs Urothelkarzinom der Harnblase Blasentumor 

Bladder cancer—current aspects of etiology, diagnosis and therapy

Abstract

Bladder cancer is still an important disease also in industrial countries. Etiologically consumptional factors as well as exposure to several toxic substances play significant roles. Due to long latency periods bladder cancer becomes manifest also a long time after exposition, which gives this disease particular relevance in occupational medicine. 90 percent of the bladder carcinoma are histologically transitional cell carcinoma. Painless hematuria is the first main symptom, dysuria and recurrent urinary tract infections may also be symptoms of bladder cancer. The gold standard in diagnostics is the cystoscopy; detection of tumor markers and urine cytology are usually applied in addition. At initial diagnosis about 80 percent of bladder cancers do not infiltrate the muscle layer and are therefore classified as non invasive. Histopathological grading following first transurethral resection is essential for further treatment. Non invasive tumors should be brought to a follow-up resection and if necessary to adjuvant intravesical instillations of chemotherapy. In case of invasive disease cystectomy is required. In advanced stages of bladder cancer cisplatinum-based chemotherapies are used.

Key words

urinary bladder bladder cancer bladder carcinoma bladder tumor urothelium cancer cancer of transitional epithelium 

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Copyright information

© Springer 2012

Authors and Affiliations

  • Folker Domnitz
    • 1
  • Stefanie Uibel
    • 1
  • David A. Groneberg
    • 1
  1. 1.Institut für Arbeitsmedizin, Sozialmedizin und UmweltmedizinGoethe-Universität Frankfurt am MainFrankfurt am MainDeutschland

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