Zusammenfassung
Urotheliale Karzinome der Harnblase zählen zu den häufigsten urothelialen Neoplasien des harnableitenden Systems. Ihr Auftreten ist geschlechts- und altersspezifisch, der typische Patient männlich und älter als 45 Jahre. Zu den Hauptrisikofaktoren zählen Rauchen und die Exposition gegenüber aromatischen Aminen. Makrohämaturie, Harnstau und -verhalt können ebenso wie die Mikrohämaturie Symptom des Urothelkarzinoms sein. Bei Auftreten letzterer sollte, nach Ausschluss einer Glomerulonephritis, eines Harnwegsinfekts oder Steinleidens, die urologische Abklärung erfolgen. Das Therapieregime ist abhängig von der Tumo- rinvasivität, nicht-invasive Tumoren werden durch transurethrale Resektion und lokale Instillation mit Immunmodulatoren wie BCG therapiert, invasive Tumoren hingegen durch eine radikale Zystektomie entfernt und mit einer adjuvanten cisplatinhaltigen Polychemotherapie behandelt. Nicht-invasive Tumoren sind mit einer deutlich höheren 5-Jahres-Überlebensrate als invasive Tumoren assoziiert (88% vs. 58%).
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Fink, S., Pahernik, S., Hallscheidt, P., Zeier, M. (2016). Urothelkarzinom. In: Adamietz, I., et al. Weiterbildung Onkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49415-8_14
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