[Infiltrating bladder tumours].
Invasive bladder tumours are defined as carcinomas infiltrating the muscular fibbers of the bladder wall. The assessment of tumour extension includes a clinical examination and an abdominopelvic computed tomography. The gold standard therapy is cystectomy in women and radical cystoprostatectomy in men. In patients with in situ bladder cancers, this treatment results in a five-year specific survival of 90 percent. Adjuvant chemotherapy may be considered in patients with extravesical lesions or lymphatic extension. After bladder resection, several types of urinary diversion may be considered. Ileal neobladder reconstruction, when possible, should be preferred. Patients must be monitored twice a year during the first 3 years, then once a year, to screen for a possible local or remote recurrence. The efficiency of the neobladder should be monitored regularly to ensure a satisfactory urinary voiding as well as continence acquisition, which can be achieved through auto-rehabilitation. In case of recurrence, therapeutic options should be debated in multidisciplinary team meetings; chemotherapy with cisplatin or/and gemcitabine remains the main therapeutic weapon.
Lebret
Thierry
T
Service d'urologie, hôpital Foch, 92150 Suresnes. t.lebret@hopital-foch.org
D015653:Cystectomy; D003952:Diagnostic Imaging; D006801:Humans; D009361:Neoplasm Invasiveness; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D014547:Urinary Diversion