Author/Editor		Sedmak, Boris
Title		Maligni tumorji mehurja
Translated title		Malignant tumors of the bladder
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 1
Publication year		2003
Volume		str. I-27-31
Language		slo
Abstract		Background. The incidence of bladder cancer is rising in Slovenia and in most countries in the world. Increasing incidence is probably due to aging population and risk factors. Approximately 75-85% of patients present with disease confined to mucosa (Ta-Tis), or submucosa (TI)stage. The other 15-25% have muscle invasion or nodal disease (stages T2-T4, N+) at presentation. Conclusions. The diagnosis of bladder cancer ultimately depends on cystoscopic examination of the bladder and histopathological evaluation of resected lesion. After transuretral resection (TUR) treatment of superficial bladder tumors (TaT1) will be directed towards the prevention of recurrence and progression with bladder instillation of vaccine for tuberculosis (bacillus Calmette-Guerin-BCG) or chemotherapeutic agents. Tumors of T2 or higher category are infiltrating tumors and cystectomy is necessary in the majority of cases. Incontinent or continent urinary diversion is presently considered after radical cystectomy. Contra-indications for cystectomy are major co-morbidity and patients not willing to accept the surgery. Bladder preservation with chemo and radiotherapy can be an option in these selected cases.
Summary		Izhodišča. Incidenca raka mehurja v večini dežel po svetu in v Sloveniji narašča. Porast incidence raka mehurja je verjetno posledica staranja prebivalstva in nevarnostnih dejavnikov oko ja. Rak mehurja je v 75-85% omejen na mukozo (stadij Ta-Tis) in submukozo stadij (T1). Ostali bolniki imajo v 25-25% mišično invazivni rak mehurja ali že zasevke v limfnih žlezah (stadij T2-T4, N+). Zaključki. Najpomembnejši diagnostični preiskavi pri raku mehurja sta cistoskopija in histopatološka ocena reseciranega tumorja. Po transuretralni resekciji površinskega raka mehurja (TaT1) jezdravljenje usmerjeno predvsem vpreprečevanjeponovitve in napredovanja bolezni z instilacijami kemoterapevtikov ali instilacijami cepiva proti tuberkulozi (bacillus Calmette-Guerin -BCG) v mehur Pri mišično-invazivnem raku mehurja (T2-T4a) je najpogosteje indicirana radikalna cistektomija. Izpeljava seča je lahko kontinentna ali pa inkontinentna. Pri bolnikih, ki odklanjajo cistektomijo ali če cistektomija ni indicirana zaradi drugih spremljajočih bolezni, je možno kombinirano zdravljenje s kemo- in radioterapijo.
Descriptors		BLADDER NEOPLASMS NEOPLASM STAGING CYSTECTOMY WORLD HEALTH ORGANIZATION