[When is surgical treatment indicated in metastatic urothelial carcinoma and what is the scientific rationale?]
BACKGROUND
Patients with metastatic urothelial carcinoma have a poor prognosis. Standard of care is a systemic chemotherapy but surgical excision of metastasis can be performed in individual approaches.


OBJECTIVE
To evaluate treatment options and study results and to identify and discuss advantages and disadvantages of metastasectomy in urothelial carcinoma.


METHODS
Database analysis and discussion of clinical trials concerning metastasectomy in urothelial carcinoma.


RESULTS
In individual cases, metastasectomy can be a reasonable additional therapeutic approach to systemic chemotherapy. Especially patients suffering from symptomatic metastatic disease benefit from extended surgical effort but further effects on survival cannot be expected.


CONCLUSIONS
Patients undergoing metastasetomy should be well selected concerning general physical condition. Metastasectomy in urothelial carcinoma remains an individual therapeutic approach and should be performed in combination with systemic chemotherapy.
Klinik für Urologie und Kinderurologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland. christian.niedworok@uk-essen.de.
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Niedworok
Klinik für Urologie und Kinderurologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
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Rübben
D002295:Carcinoma, Transitional Cell / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery*; D015653:Cystectomy / Q000401:mortality* / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control; D015995:Prevalence; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*
Chemotherapy; Lymph node metastasis; Metastasectomy; Metastatic urothelial cancer; Salvage operation