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Der Klinikarzt 2017; 46(09): 444-448
DOI: 10.1055/s-0043-118517
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Organerhaltende Therapieoptionen des muskelinvasiven Harnblasenkarzinoms

Partielle Zystektomie und Multimodale Therapie
Carsten Kempkensteffen
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Publication History

Publication Date:
20 September 2017 (online)

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Zusammenfassung

Die radikale Zystektomie gilt gemäß nationaler und internationaler Leitlinien als Therapie der Wahl zur Behandlung des muskelinvasiven Harnblasenkarzinoms. Insbesondere bei alten, komorbiden Patienten ist dieser Eingriff jedoch mit einem relativ hohen Komplikationsrisiko assoziiert. Jüngere Patienten befürchten darüber hinaus vor allem postoperative Einschränkungen der Lebensqualität durch Störungen der Sexualität, der Kontinenz und des Körperbildes infolge der möglicherweise notwendigen Anlage eines Urostomas. Daraus resultiert eine zunehmende Nachfrage nach alternativen, organerhaltenden Therapieoptionen. Hier stehen derzeit die multimodale Therapie und die partielle Zystektomie im Vordergrund. Unter der Voraussetzung einer stringenten Patientenselektion sowie einer engmaschigen Tumornachsorge, lassen sich mit beiden Verfahren der radikalen Zystektomie vergleichbare onkologische Ergebnisse erreichen.

 

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