肌层浸润性膀胱癌保膀胱治疗的探索与进展

ABSTRACT：muscle-invasivebladder cancer（MIBC）is asubtypeof bladder cancer with ahigh incidence and mortalityrate， making its treatment a key focus inclinical practice.The gold standardtreatmentof MIBC is neoadjuvant chemotherapy（NAC） plus radical cystectomy（RC）with pelvic lymphadenectomy.However，the 5- and 10-year overall survival（OS）were 49% and 36% ，respectively，with high morbidity.Withadeeper understanding of thebiological characteristicsof MIBC，comprehensive treatment strategies haveevolved，offeringthe posibilityof bladderpreservationforpatients.Thisreviewsystematically summarizes thecurrnt criteria for patient selection，past experiences，and clinicaloutcomes of bladder-sparing treatments for MIBC，with aparticular emphasis on the value of trimodal therapyandcombined immunotherapy.Additionally，the paper explores theimportanceoffollow-upmonitoringandfuture perspectives ontreatment strategies，including the potentialof individualized andmultimodaltherapies.Throughmultidisciplinarycollaborationandintegrationofemerging therapies， comprehensive managementofMIBCaims notonlytoextend patientsurvival butalso toimprove thequalityof ifeeffectively.

KEY WORDS：muscle-invasive bladder cancer;bladder-sparing therapy；trimodal therapy；immune checkpoint inhibitors

关键词：肌层浸润性膀胱癌；膀胱保留治疗；三联模式治疗；免疫检查点抑制剂中图分类号：R737.14 文献标志码：A

DOI：10.3969/j.issn.1009-8291.2025.10.001

膀胱癌在全球范围内已成为最常见的恶性肿瘤之一，肌层浸润性膀胱癌（muscle-invasivebladdercancer，MIBC）指肿瘤侵入膀胱肌层的膀胱癌，其临床特征和治疗方式与非肌层浸润性膀胱癌（nonmuscle-invasivebladdercancer，NMIBC）显著不同。（剩余12434字）