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KMID : 1001020080060030111
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Journal of Urologic Oncology
2008 Volume.6 No. 3 p.111 ~ p.116
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How do You Manage High Risk Bladder Cancer?
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Chung Jae-Il
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Abstract
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Urothelial cancers are most common urological cancers in Korea. Bladder cancers are divided into two category. One is non-muscle-invasive bladder cancer (NMIBC) and another is muscle invasive bladder cancer. Nonmuscle- invasive bladder cancer is including stage Ta, T1, and CIS (carcinoma in situ). High risk bladder cancer included T1, high grade, and CIS. Approxiately 70% of bladder tumors are NMIBC at presentation. Of these, 70% present as Ta, 20% as T1, and 10% as CIS. Recurrence and progression to high stage are common, especially in high risk patients. So I review that how to reduce the recurrence and progression in high risk bladder cancer. There are four steps in this view: complete resection of tumor, prevent reimplataion of tumor cells, microablation, and prophylaxis. Most important thing is complete resection of tumor and get muscle specimen for exact pathologic staging. Perioperative intravesical chemotherapy is effective for preventing reimplation. Epirubicin and mitomycin -C are available. For microablation, intravesical BCG or chemotherapeutic agents instillation has been used. There were no standard method of instillation but single course (6 week or 8 weeks schedule) is not enough and additional treatment was mandatory. And lastly, cease smoking and take some drug for prophylaxis is important for preventing recurrence and progression.
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KEYWORD
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High risk bladder cancer, Manage
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