Muskelinvasives blasenkarzinom: Funktionserhaltende zystektomie und harnableitung im jahr 2012

The aim of the treatment of invasive bladder cancer with radical cystectomy and subsequent urinary diversion is to combine a safe oncological procedure with a satisfactory quality of life. Radical cystectomy is the treatment of choice for all patients with recurrent or multifocal high-grade T1 bladder cancer, T1 tumors at high risk of progression, failure of bacillus Calmette-Guérin (BCG) treatment and muscle-invasive bladder cancer. Radical cystectomy offers excellent recurrence-free and cancer-specific survival rates as well as local tumor control in patients with organ-confined and node-negative diseases. Tumor control in non-organ-confined tumors is still satisfactory with long-term relapse-free survial rates of about 50%. Nerve-sparing cystectomy is of importance for the lower urinary tract function, including continence rates after orthotopic urinary diversion and for sexual function in males and females. Orthotopic urinary reconstruction using a neobladder achieves good continence rates. Overall quality of life after radical cystectomy remains good in most patients irrespective of urinary diversion type.