文献詳細
特集 ここが知りたい! 筋層非浸潤性膀胱癌─エキスパートが答える日常診療の疑問点
〈再発腫瘍に対する治療方針〉
文献概要
質問 : 初発高リスク群(Ta/T1腫瘍)に対してBCG膀胱内注入療法施行後,初回の再発時にはどのような治療をすればよいでしょうか?
▶ポイント
・初発高リスク群であってもBCG治療後の初回再発時に中リスク群であれば,再度BCG治療で再発予防効果はある程度期待できる.
・ガイドラインが提唱するBCG治療後のhigh grade再発腫瘍に対する治療の第一選択は膀胱全摘除術である.
・BCG治療後のhigh grade再発に対する膀胱全摘除術の利点は,比較的高い制癌効果,より確実な局所コントロール,患者への経過観察の負担軽減が挙げられる.
▶ポイント
・初発高リスク群であってもBCG治療後の初回再発時に中リスク群であれば,再度BCG治療で再発予防効果はある程度期待できる.
・ガイドラインが提唱するBCG治療後のhigh grade再発腫瘍に対する治療の第一選択は膀胱全摘除術である.
・BCG治療後のhigh grade再発に対する膀胱全摘除術の利点は,比較的高い制癌効果,より確実な局所コントロール,患者への経過観察の負担軽減が挙げられる.
参考文献
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