Mesane Kanseri
Özet
Mesane kanseri, üriner sistemin en sık görülen malignitesidir. Erken tanıda ağrısız hematüri ve irritatif işeme semptomları önemli olmakla birlikte, benign patolojilerle benzerlik nedeniyle tanı gecikmeleri görülebilmektedir.
TNM 8 evreleme sistemine göre, mesane kanseri kasa invaze olmayan (NMIBC: Ta, Tis, T1), kasa invaze (MIBC: T2-T4) ve metastatik olarak sınıflandırılır. Transüretral rezeksiyon (TURBT) sonrası tekrarlayan TURBT, intravezikal tedaviler risk sınıflandırmasına (düşük, orta, yüksek) göre uygun protokollerle uygulanır.
Takip protokolleri risk sınıflamalarına göre kişiselleştirilir. Risk kategorisine göre sistoskopi ve üst üriner sistem görüntülemesi önerilir. İdrar sitolojisi ve moleküler belirteçler tamamlayıcı olarak kullanılabilse de özgüllükleri sınırlıdır. Üst üriner trakt ve metastatik odakların takibinde BT, MRI ve FDG-PET/BT kritik rol oynar.
Mesane kanseri yönetimi evreye, histolojik özelliklere ve hasta risk faktörlerine göre uyarlanmalıdır. Tekrarlayan TURBT ve risk bazlı intravezikal tedaviler rekürrens ve progresyonu azaltmada etkilidir. Takip stratejileri, kişiselleştirilmiş yaklaşımla planlanmalı; yeni semptomlar veya biyolojik belirteçler ışığında dinamik olarak güncellenmelidir. Optimal takip sürelerinin belirlenmesi için ileri çalışmalara ihtiyaç bulunmaktadır.
Bladder cancer is the most common malignancy of the urinary system. With early diagnosis, hematuria and irritant urination are a significant part of the disease, and diagnostic delays may occur due to similarity with benign pathologies.
According to the TNM 8 staging system, bladder cancer is classified as non-muscle invasive (NMIBC: Ta, Tis, T1), muscle-invasive (MIBC: T2-T4) and metastatic. Repeated TURBT and intravesical treatments after transurethral resection (TURBT) are applied with appropriate protocols according to risk symptoms (low, medium, high).
Follow-up protocols are personalized according to risk classifications. Cystoscopy and upper urinary tract reduction are recommended depending on the risk category. Although their site examples and details can be used as complementary markers, we encounter their specificity. CT, MRI and FDG-PET/CT play a critical role in the follow-up of high-level tracts and metastatic foci.
Bladder cancer management should be tailored to the environment, histological data, and patient risk. Repeat TURBT and risk-based intravesical therapies are effective in reducing recurrence and progression. It should be planned with follow-up pieces and a personalized approach. Those that need to be specified as new or biological should be updated dynamically. Further studies are needed to determine optimum follow-up periods.
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