How is bladder tumor treated?
The treatment of bladder cancer is based on surgical treatment, which is divided into non-muscle infiltration and muscle infiltration according to the depth of tumor infiltration.
Bladder tumors with non-muscle layer infiltration (Ta-T1 stage) should be treated with transurethral resection of bladder tumor (TUR-BT), followed by postoperative chemotherapy with bladder perfusion. There are various perfusion regimens, commonly used are postoperative once a week for a total of 8 times, then changed to once a month for a total of 10 times for a year. The main perfusion drugs are epirubicin, mitomycin, pirarubicin, adriamycin, and hydroxycamptothecin, with essentially the same effect. BCG (BCG) has the best perfusion effect, but it has the potential to cause severe irritation, bladder contracture, and tuberculosis dissemination, and is less commonly used clinically for patients with high-risk bladder cancer.
Radical cystectomy with concomitant pelvic lymph node dissection should be performed for muscle-infiltrating bladder tumors. This procedure is the standard of care for muscle-infiltrating bladder cancer and is an effective treatment to improve the survival rate of patients with invasive bladder cancer and to avoid local recurrence and distant metastasis. Radical cystectomy can also be performed for high-risk non-muscle invasive bladder cancer T1G3 tumors, carcinoma in situ that has failed to respond to BCG therapy, recurrent non-muscle invasive bladder cancer, and extensive papillary lesions that cannot be controlled by TUR or endoluminal surgery alone.
For patients with invasive bladder cancer who are physically unable to tolerate radical cystectomy or unwilling to undergo radical cystectomy, comprehensive treatment with bladder preservation can be considered.
Adjuvant chemotherapy or radiotherapy is feasible for advanced bladder tumors, and the GC regimen is the mainstay of chemotherapy.