[Carcinoma in situ of the urinary bladder--definition and status of treatment].
Carcinoma in situ is a noninvasive intraepithelial disease without papillary growth. Anaplasia and a disarranged growth form of the epithelium are histopathological characteristics. Carcinoma in situ can appear as a secondary disease combined with a papillary tumour or after transurethral resection of a papillary tumour. On the other hand, primary carcinoma in situ is also known to appear without a papillary tumour. Symptoms of cystitis are often seen. Sometimes, however, the disease does not cause any symptoms. Urinary cytology is the most important noninvasive investigation, followed by biopsy of the bladder epithelium. Treatments commonly applied at present are intravesical immunotherapy with BCG and intravesical chemotherapy. Photodynamic laser therapy is presently being investigated. Carcinoma in situ is very significant as a prognostic factor. The progression rate is up to 83%, and progression signifies development of a poorly differentiated invasive bladder cancer. The treatment of choice for inefficiently treated carcinoma in situ is cystectomy. The urinary diversion selected in men depends on the histopathological findings in the prostatic urethra; an ileum neobladder, the standard diversion in men, cannot be performed if carcinoma in situ has been found in the prostatic urethra.
Otto
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Urologische Klinik und Poliklinik, Universitäts-GHS, Essen.
Rübben
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H
D000283:Administration, Intravesical; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001500:BCG Vaccine / Q000008:administration & dosage*; D002278:Carcinoma in Situ / Q000473:pathology / Q000628:therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D011379:Prognosis; D011994:Recombinant Proteins; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
D000970:Antineoplastic Agents; D001500:BCG Vaccine; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins
Das Carcinoma in situ der Harnblase--Definition und Stand der Behandlung.