Professional paper

https://doi.org/10.26800/LV-141-11-12-42

Clinical recommendations for diagnosis, treatment and monitoring of patients with bladder cancer

Marijana Jazvić ; Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Sestre milosrdnice, Zagreb
Boris Ružić ; Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Sestre milosrdnice, Zagreb
Božo Krušlin ; Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Sestre milosrdnice, Zagreb
Marijan Šitum ; Medicinski fakultet Sveučilišta u Splitu, Klinički bolnički centar Split, Split
Valdi Pešutić Piasc ; Medicinski fakultet Sveučilišta u Splitu, Klinički bolnički centar Split, Split
Tomislav Omrčen ; Medicinski fakultet Sveučilišta u Splitu, Klinički bolnički centar Split, Split
Tihana Boraska Jelavić ; Medicinski fakultet Sveučilišta u Splitu, Klinički bolnički centar Split, Split
Marija Gamulin ; Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Zagreb, Zagreb
Ana Marija Alduk ; Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Zagreb, Zagreb
Marijana Čorić ; Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Zagreb, Zagreb
Jure Murgić ; Medicinski fakultet Sveučilišta u Zagrebu, Klinički bolnički centar Sestre milosrdnice, Zagreb
Berislav Mažuran ; Klinička bolnica „Sveti Duh“, Zagreb
Kristina Šitum ; Medicinski fakultet Sveučilišta u Splitu, Klinički bolnički centar Split, Split 3
Maja Drežnjak Madunić ; Medicinski fakultet J. J. Strossmayera u Osijeku, Klinički bolnički centar Osijek, Osijek
Damir Miletić ; Medicinski fakultet Sveučilišta u Rijeci, Klinički bolnički centar Rijeka, Rijeka
Željko Vojnović ; Opća bolnica Varaždin, Varaždin

Abstract

Bladder cancer is the second most common malignancy of urinary system according to data from the Croatian National Cancer Registry for 2015. In 90% of cases the underlying histology is urothelial carcinoma.
Difference in survival in patients with muscle-invasive disease (MIBC) compared to the survival of patients with non-muscle invasive disease (NMIBC) is enormous. Management of NMIBC, traditionally, has been focused on the reduction of subsequent bladder recurrence and prevention of disease progression and is primarily based on transurethral resection (TUR) of the tumor, followed by intravesical therapy based on estimated individual risk of recurrence. Conversely, in patients with MIBC radical cystectomy remains the corne stone of the treatment, optimally in conjunction with neoadjuvant platinum-based chemotherapy in cisplatin-eligible patients. At the moment of
diagnosis, 4–6% of patients already have distant metastases, and post cystectomy recurrence could be expected in 50% of patients. Treatment options in metastatic disease range from cisplatin-based chemotherapy, immunotherapy, palliative radiotherapy and finally supportive care. Landmark feature of bladder cancer is the high prevalence
of somatic mutations which enabled profound change for decades held treatment paradigm for advanced bladder cancer leading to regulatory approval of whole array of novel immunotherapy agents. These emerging therapeutics (programmed death ligand-1 (PD-L1) and programmed cell death protein-1 (PD-1)) belong to the
class of inhibitors of checkpoint proteins, which are key targets that regulate T-cell mediated immune response.

Keywords

URINARY BLADDER NEOPLASMS – diagnosis, pathology, therapy; CARCINOMA, TRANSITIONAL CELL – diagnosis, pathology, therapy; NEOPLASM STAGING; UROLOGIC SURGICAL PROCEDURES – methods; CYSTECTOMY; ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS – therapeutic use; CISPLATIN – therapeutic use; COMBINED MODALITY THERAPY; PRACTICE GUIDELINES AS TOPIC; CROATIA

Hrčak ID:

232868

URI

https://hrcak.srce.hr/232868

Publication date:

31.1.2020.

Article data in other languages: croatian

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