Surgical management of bladder carcinoma.
BACKGROUND
Despite advances in medical oncology, radiation therapy, and molecular and cell biology, the mainstay in the management of bladder cancer continues to be surgery.


METHODS
The authors reviewed the literature regarding the endoscopic diagnosis and management of bladder cancer as well the role of partial and radical cystectomy.


RESULTS
Cystoscopy and transurethral resection are required to diagnose and stage bladder cancer. The indications for random bladder biopsies, prostatic urethral biopsy, and re-resection of the tumor bed are examined. The results and complications of endoscopic resection in the management of Ta, T1, and T2 or greater bladder cancer are reported. The roles of partial cystectomy, radical cystectomy, extent of lymphadenectomy, and indications for urethrectomy are also examined. The results and complications of radical cystectomy for the management of T2, T3, T4, and N+ bladder cancer are reported.


CONCLUSIONS
Surgery remains a critical element in the management of bladder cancer. Improvements in surgical technique, urinary reconstruction, and multimodal therapy continue to improve the prognosis and quality of life of patients with transitional cell cancer of the bladder.
Carrion
Rafael
R
Division of Urology, University of South Florida, Tampa, 33620, USA.
Seigne
John
J
D015653:Cystectomy / Q000379:methods; D003558:Cystoscopy / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012737:Sex Factors; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*