Einfluss der Komorbidität auf die Mortalität und Morbidität bei der radikalen Zystektomie

Zusammenfassung

Die radikale Zystektomie (RZE) mit pelviner Lymphadenektomie stellt aktuell die Goldstandard-Therapie beim muskelinvasiven Urothelkarzinom und schlechtdifferenzierten, instillationsrefraktären nichtmuskelinvasiven Urothelkarzinom der Harnblase dar. Auch wenn die RZE in kurativer Absicht vollzogen wird, ist das 5-Jahres Gesamtüberleben in der Literatur mit 62% angegeben. Verschiedene klinische und histopathologische Kriterien determinieren das Outcome nach der RZE. Abgesehen davon, spielen die Begleiterkrankungen eine nicht untergeordnete Rolle. Bereits in den aktuellen Richtlinien der Europäischen Gesellschaft für Urologie werden verschiedene Komorbiditäts-Indizes, zur Quantifizierung der Begleiterkrankungen diskutiert. In dieser Übersichtsarbeit werden verschiedene Komorbiditätsindizes, welche als Vorhersageparameter in verschiedenen RZE Studien angewandt wurden beleuchtet.

Abstract

Radical cystectomy (RC) with bilateral pelvic lymph node dissection constitutes the gold standard treatment for muscle-invasive and high-risk non-muscle-invasive urothelial carcinoma of the bladder refractory to instillation therapy. Although radical cystectomy is performed with curative intent, the overall 5-year survival has been reported to be as low as 62% in the current literature. Various clinico-pathological parameters determine post-RC outcome, but besides these, the role of comorbidity has gained increasing attention and can be quantified with various comorbidity scores. We here review the most recent data on comorbidity scores and performance indices, which have been assessed in patients, undergoing RC and highlight their clinical implications.

Schlüsselwörter

Begleiterkrankungen - Komplikationen - Morbidität - 90-Tagesmortalität - Urothelkarzinom

Key words

comorbidity - complications - morbidity - 90-day mortality - bladder cancer

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