NCCN膀胱癌指南2015年V2.0版中文版

NCCN Guidelines Index Bladder Cancer TOC Discussion
Jerome P. Richie, MD ϖ Dana-Farber/Brigham and Women’s Cancer Center Wade J. Sexton, MD ϖ Moffitt Cancer Center William U. Shipley, MD § Massachusetts General Hospital Cancer Center Eric J. Small, MD † ϖ UCSF Helen Diller Family Comprehensive Cancer Center Guru Sonpavde, MD † University of Alabama at Birmingham Comprehensive Cancer Center Donald L. Trump, MD † Roswell Park Cancer Institute Jonathan Tward, MD, PhD § Huntsman Cancer Institute at the University of Utah Geoffrey Wile, MD ф Vanderbilt-Ingram Cancer Center Timothy G. Wilson, MD ϖ City of Hope Comprehensive Cancer Center NCCN Mary Dwyer, MS Courtney Smith, PhD Sarika Trikha, PharmD
膀胱癌ＮＣＣＮ指南２０１５．２版
目录
膀胱癌
• •
临床表现及初始评估 非侵袭性病灶，或Ｔｉｓ，检查，初始评估／手术治疗（ＢＬ－１） 二次手术治疗，膀胱内辅助治疗，随访（ＢＬ－２） ｃＴａ，ｃＴ１，复发或持续性病灶术后治疗（ＢＬ－３）
NCCN Guidelines Index Bladder Cancer TOC Discussion
膀胱癌ＮＣＣＮ指南２０１５．２版
* Peter E. Clark, MD ϖ Chair
Vanderbilt-Ingram Cancer Center Jeff Michalski, MD, MBA § Siteman Cancer Center at BarnesJewish Hospital and Washington University School of Medicine Jeffrey S. Montgomery, MD, MHSA ϖ University of Michigan Comprehensive Cancer Center Lance C. Pagliaro, MD † The University of Texas MD Anderson Cancer Center Sumanta K. Pal, MD † City of Hope Comprehensive Cancer Center Anthony Patterson, MD ϖ St. Jude Children’s Research Hospital/ University of Tennessee Health Science Center Daniel Petrylak, MD † Yale Cancer Center/Smilow Cancer Hospital Elizabeth R. Plimack, MD, MS † Fox Chase Cancer Center Kamal S. Pohar, MD ϖ The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute Michael P. Porter, MD, MS ϖ Fred Hutchinson Cancer Research Center/ Seattle Cancer Care Alliance
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®)
Bladder Cancer 膀胱癌ＮＣＣＮ指南
Version 2.2015
（内部资料，仅供学习交流）
编译：盛锡楠 张崔健 李永恒 刘毅强 鄢谢桥 白 雪 周 莉 审校：郭 军 何志嵩 曹登峰 北京大学肿瘤医院 北京大学第一医院 中国医学科学院肿瘤医院
•
肌层受累或转移性病灶：检查，初始初始评估／手术治疗（ＢＬ－１） ｃＴ２初始和辅助治疗（ＢＬ－４） ｃＴ３，ｃＴ４ａ初始和辅助治疗（ＢＬ－５） ｃＴ４ｂ和转移性病灶，额外检查，初始和辅助治疗（ＢＬ－６） 复发或持续性病灶随访（ＢＬ－７） • 手术处理原则（ＢＬ－Ａ） • 病理处理原则（ＢＬ－Ｂ） • 复发风险（ＢＬ－Ｃ） • 膀胱非尿路上皮癌（ＢＬ－Ｄ） • 膀胱切除或部分切除后随访（ＢＬ－Ｅ） • 膀胱内治疗处理原则（ＢＬ－Ｆ） • 化疗处理原则（ＢＬ－Ｇ）
前列腺电切活检
• 病史＆查体
可疑尿路上皮癌
Tis
• 膀胱镜 • 细胞学检查
Version 2.2015, 05/21/15 © National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®.
膀胱癌ＮＣＣＮ指南２０１５．２版
临床表现 初始检查 假定的 临床分期 检查 初始评估／手术
NCCN Guidelines Index Bladder Cancer TOC Discussion cTac cT1c
乳头状肿瘤
See BL-2 See BL-2 See BL-4 See BL-5 See BL-6 See BL-2
* Philippe E. Spiess, MD, MS ϖ Vice chair
Moffitt Cancer Center Neeraj Agarwal, MD ‡ Huntsman Cancer Institute at the University of Utah Stephen Boorjian, MD ϖ Mayo Clinic Cancer Center Thomas W. Flaig, MD † University of Colorado Cancer Center Richard E. Greenberg, MD ϖ Fox Chase Cancer Center Noah Hahn, MD † The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Harry W. Herr, MD ϖ Memorial Sloan Kettering Cancer Center Brant A. Inman, MD, MSc ϖ Duke Cancer Institute A. Karim Kader, MD, PhD ϖ UC San Diego Moores Cancer Center Timothy M. Kuzel, MD ‡ Robert H. Lurie Comprehensive Cancer Center of Northwestern University Subodh M. Lele, MD ≠ Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center
Version 2.2015, 05/21/15 © National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®.
Version 2.2015, 05/21/15 © National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®.
上尿路肿瘤
• •
肾盂（ＵＴＴ－１） 输尿管尿路上皮癌（ＵＴＴ－２） 前列腺尿路上皮癌（ＵＣＰ－１） 尿道原发肿瘤（ＰＣＵ－１）
The NCCN Guidelines® are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult the NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The National Comprehensive Cancer Network® (NCCN®) makes no representations or warranties of any kind regarding their content, use or application and disclaims any responsibility for their application or use in any way. The NCCN Guidelines are copyrighted by National Comprehensive Cancer Network®. All rights reserved. The NCCN Guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN. ©2015.
Continue
NCCN Guidelines Panel Disclosures
ห้องสมุดไป่ตู้
ϖ Urology † Medical oncology ‡ Hematology/Hematology oncology § Radiotherapy/Radiation oncology
ф Diagnostic radiology ≠ Pathology * Writing committee member
• 上尿路系统成像
a
• 麻醉下检查（ＥＵＡ）
（双合诊）
cT2c cT3, cT4ac
ｃＴ４ｂ，和转移
c
• 若肿瘤为高分级，或
非肌层浸润性 附壁生长，在经尿道 膀胱肿瘤切除（ＴＵＲＢＴ） 前可考虑行盆腔ＣＴ或 核磁
• TURBT b • 若肿瘤无蒂，或可疑 高分级，或Ｔｉｓ 选择性定位活检 可考虑经尿道