Organerhaltende Therapieoptionen des muskelinvasiven Harnblasenkarzinoms

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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