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Alternative Verfahren bei Urothelkarzinom

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Zusammenfassung

Die Prognose des Urothelkarzinoms der Harnblase wird im Wesentlichen geprägt von den Kriterien Infiltrationstiefe und Differenzierungsgrad im Tumor. Um das Rezidiv- und Progressionsrisiko so gering wie möglich zu halten, werden nach transurethraler Blasentumorresektion (TUR-B) adjuvante Konzepte der Blaseninstillationstherapie angewandt (Mitomycin C und Bacillus-Calmette-Guérin). Möglicherweise kann das Rezidivrisiko durch den Einsatz der Hyperthermie in Verbindung mit Mitomycin weiter gesenkt werden. Für Patienten, die aus Altersgründen, aufgrund von Komorbiditäten oder einfach auch wegen des Wunsches nach Organerhalt eine Zystektomie beim muskelinvasiven Harnblasentumor ablehnen, besteht die Möglichkeit einer kombinierten Radiochemotherapie. Grundvoraussetzung ist eine geringe Resttumorlast nach TUR-B. Blasenteilresektionen bleiben nur streng selektionierten Patientengruppen mit guter Blasenkapazität, unifokalen Tumoren und einer hohen Compliance vorbehalten.

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Kempkensteffen, C., Miller, K., Höcht, S., Nausner, M., Christoph, F. (2016). Alternative Verfahren bei Urothelkarzinom. In: Schostak, M., Blana, A. (eds) Alternative operative Therapien in der Uroonkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44420-7_3

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