Nur die Chirurgie? Multimodalkonzepte mit kurativer Intention für das Urothelkarzinom der Harnblase

Zusammenfassung

Die radikale Zystektomie ist der Goldstandard zur Behandlung des muskelinvasiven Urothelkarzinoms. Insbesondere bei Patienten mit fortgeschrittenen Tumoren spielen multimodale, neoadjuvante oder adjuvante Therapiekonzepte eine zunehmend wichtige Rolle für die optimale Patientenversorgung. Zudem sind bei älteren und komorbideren Patienten, die unfit für eine radikale Zystektomie sind, alternative Therapiekonzepte erforderlich. Dieser Artikel fasst die aktuelle Literatur multimodaler Therapien im neoadjuvanten und adjuvanten Setting zusammen und beleuchtet Alternativen zur radikalen Zystektomie mit kurativem Therapieansatz. Ebenfalls werden erste Erkenntnisse über den Einsatz neuer, vielversprechender Therapieoptionen wie der Immuncheckpoint-Blockade im multimodalen Therapieansatz zusammengefasst.

Abstract

Radical cystectomy is the gold standard in treatment of muscle invasive bladder carcinoma. Especially for patients with advanced tumours, multimodal therapies play an important role in optimising patient care. In older patients with multiple comorbidities, who are not eligible for surgery, alternative treatment modalities are needed as well. This article summarises the current literature on multimodal treatment options in a neoadjuvant and adjuvant setting and analyses alternative potentially curative treatments. The article also summarises the initial results using checkpoint inhibitors in a multimodal treatment setting.

Schlüsselwörter

Urothelkarzinom - Radikale Zystektomie - Perioperative Chemotherapie - Multimodale Therapie - Trimodale Therapie

Keywords

Urothelial carcinoma - Multimodal therapy - Perioperative chemotherapy - Radical cystectomy - Trimodal therapy

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