[Locally advanced or oligometastatic bladder cancer-role of local treatment of the primary tumor and metastases]. / Lokal fortgeschrittene oder oligometastasierte Blasenkarzinome ­ Stellenwert der Lokaltherapie von Primärtumor und Metastasen.

ABSTRACT

BACKGROUND: Treatment of muscle invasive bladder cancer can be challenging since treatment is associated with significant side effects and complication rates-especially in patients who often present with relevant comorbidities. In the metastatic stage, the purpose of treatment is palliation, although the oligometastatic stage takes a distinct role. At this stage, treatment of the primary tumor can play a role, if metastasis can be treated locally in addition to systemic treatment, especially the evolving drug treatment landscape could also change long holding paradigms in the near future. OBJECTIVES: This review focuses on the influence of definitive treatment of the primary tumor in patients with oligometastatic urothelial bladder cancer. MATERIALS AND METHODS: Based on a literature search, the aim was to summarize data and give an overview on treatment of oligo-metastatic bladder cancer with focus on treatment of the primary tumor. Presented data derived mostly from retrospective studies and meta-analyses. CONCLUSION: Local treatment of the primary tumor in context of a multimodal therapy of lymph node metastatic or oligometastatic bladder cancer can have a positive influence on survival, quality of life and prevention of local complications in selected patients. The choice of local treatment should follow the same criteria as in non-metastatic bladder cancer.