[TNM-oriented therapy planning in bladder cancer].
The standard diagnostic procedures for bladder carcinoma include transurethral resection, bimanual palpation of the bladder under general anaesthesia, ultrasound examination and CT scan of the abdominal and pelvic regions. An IVP is additionally carried out for the detection of concomitant upper urinary tract tumours. Preoperative urinary cytology is also performed, as in 10% of all patients the degree of malignancy of bladder cancer according to the TNM system is revealed more exactly by cytology than by histology. New computerized examination techniques have been designed in attempts to improve the accuracy of the diagnostic process. Therapeutic modalities according to the classification of bladder carcinoma in the TNM system have to be based on the different efficacies of the diagnostic procedure: In superficial low-grade tumours the diagnostic efficacy is quite high, so that transurethral resection remains the treatment of choice. Superficial high-grade tumours are attended by reduced 5-year survival rates, and patients with such tumours must therefore be regarded as a high-risk group. In muscle-invasive bladder carcinoma reduced diagnostic efficacy and unsatisfactory treatment results are seen, so that in this condition cystectomy at an early stage is indicated.
Goepel
M
M
Urologische Klinik und Poliklinik, Universität, GHS, Essen.
Rübben
H
H
D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002278:Carcinoma in Situ / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery
D014408:Biomarkers, Tumor
TNM-orientierte Therapieplanung beim Harnblasenkarzinom.