Optimizing cystectomy outcomes in muscle-invasive bladder cancer: what's new in 2025?

IF 2.8 3区医学 Q2 ONCOLOGY

Expert Review of Anticancer Therapy Pub Date : 2025-07-27 DOI:10.1080/14737140.2025.2535657

Taeweon Lee, Landan MacDonald, Tarek Lawen, Ashish M Kamat

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引用次数: 0

Abstract

Introduction: Radical cystectomy (RC) remains the gold standard surgical treatment for muscle-invasive bladder cancer (MIBC). It is a technically complex procedure with considerable short- and long-term morbidity, even in experienced hands.

Areas covered: This review highlights recent advances in the multidisciplinary management of MIBC across the pre-, peri-, and post-operative phases. Improvements in surgical technique, peri-operative care pathways, and systemic therapies - including immunotherapy - have transformed outcomes. A targeted literature search was conducted using PubMed, Scopus, and Web of Science for English-language articles from 2015-2024, focusing on prospective studies from seminal clinical trials. Salient strategies were selected for inclusion based on clinical relevance and impact on patient outcomes.

Expert opinion: Optimizing outcomes for patients undergoing RC requires an evidence-based, patient-centered approach. The addition of immunotherapy in the peri-operative setting has changed the standard of care. In the future, peri-operative treatment decisions may be guided by biomarkers such as circulating tumor DNA. Additionally, optimizing patient comorbidities, delivering individualized patient education, and adhering to enhanced recovery protocols remain essential to optimizing patient outcomes.

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优化肌肉浸润性膀胱癌的膀胱切除术结果：2025年有什么新进展？

导言：根治性膀胱切除术（RC）仍然是肌肉浸润性膀胱癌（MIBC）的金标准手术治疗方法。这是一个技术上复杂的程序，具有相当大的短期和长期的发病率，即使在经验丰富的手。涵盖领域：本综述强调了在手术前、围手术期和术后阶段对MIBC多学科管理的最新进展。手术技术、围手术期护理途径和全身治疗（包括免疫治疗）的改进已经改变了预后。使用PubMed、Scopus和Web of Science对2015-2024年的英文文章进行了针对性的文献检索，重点关注开创性临床试验的前瞻性研究。根据临床相关性和对患者预后的影响，选择突出策略纳入。专家意见：优化接受RC的患者的结果需要循证、以患者为中心的方法。围手术期免疫治疗的加入改变了护理标准。在未来，围手术期的治疗决定可能由生物标志物如循环肿瘤DNA来指导。此外，优化患者的合并症，提供个性化的患者教育，并坚持增强的恢复方案仍然是优化患者结果的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.