新辅助治疗后影像阴性是否无需清扫？新技术又如何重塑膀胱癌淋巴结切除标准？
Apr 15, 20268mEp. 60
现状与挑战：影像阴性的隐匿风险 约30%新辅助治疗后影像学阴性（cN0）的MIBC患者存在淋巴结微转移，传统CT/MRI的敏感度仅65%，特异性82%。即使PET-CT（敏感度75%）仍可能漏诊
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Updated 8 days ago · Refreshed hourly
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SWOG S1001淋巴结清扫策略是否到了变局时刻
Hosted by Unknown Host · 🇺🇸 US · ZH · 6 episodes
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9m
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ZH
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特邀专家： 江苏省人民医院 吕强 教授 复旦大学附属肿瘤医院 沈益君 教授 上海交通大学医学院附属仁济医院 陈海戈 教授 主持： 上海交通大学医学院附属仁济医院 张瑞赟 教授
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Unknown Host hosts SWOG S1001淋巴结清扫策略是否到了变局时刻, a general show with 6 episodes published.
Recent episodes
Our AI reads these to draft pitches
综合治疗时代下基于SWOG S1011研究的淋巴结清扫范围再评估启示
Apr 15, 202610mEp. 40
从扩大清扫到综合治疗的范式转变 SWOG S1011研究颠覆了肌层浸润性膀胱癌（MIBC）根治术中「扩大淋巴结清扫改善生存」的传统认知。在免疫治疗、新辅助化疗等系统治疗日益成熟的今天，外科手术的角色正从「最大程度切除」转向「精准功能保护」。研究显示，扩大清扫组与标准组的5年总生存率无差异（48% vs 51%, p=0.36），而严重并发症风险增加23%，提示 过度清扫可能抵消系统治疗的生存增益 。 临床实践变革：外科与系统治疗的协同优
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新辅助治疗后膀胱癌CR患者能否免于手术与淋巴结清扫？
Apr 15, 20265mEp. 50
CR患者的治疗困境 约25%-30%的肌层浸润性膀胱癌（MIBC）患者在新辅助化疗/免疫治疗后达到临床完全缓解（cCR，定义为影像学+膀胱镜活检阴性），但其中15%-20%仍存在隐匿性微转移。目前争议焦点在于： 手术切除是否必要？若需手术，淋巴结清扫范围如何界定 ？ 临床决策流程：吕强教授团队的实践标准 1. CR验证 ： · 影像学 ： MRI评估原发灶（Vesical Imaging-Reporting and Data Syste
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从数据看膀胱癌手术变革：扩大淋巴结清扫的并发症风险与高危患者精准分层获益
Apr 15, 20269mEp. 30
研究核心发现：扩大清扫显著升高并发症风险 SWOG S1011研究显示，扩大淋巴结清扫组术后并发症发生率显著高于标准组（50% vs 44%），3级以上严重事件（如重度贫血、脓毒症）风险增加27%。值得注意的是，研究覆盖2001-2017年多中心数据，手术方式涵盖开放、腹腔镜及机器人辅助，提示技术演变未能抵消扩大清扫的固有风险。此外，扩大清扫可能通过淋巴系统破坏导致低蛋白血症、肠道水肿等连锁反应，进而延长住院时间（中位延长3.5天，p=
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高危非肌层浸润性膀胱癌淋巴结清扫的争议与探索：多中心临床研究与中国实践
Apr 15, 202610mEp. 20
清扫必要性的核心矛盾 在膀胱癌治疗中，肌层浸润性膀胱癌（MIBC）的淋巴结清扫已形成共识，但高危非肌层浸润性膀胱癌（NMIBC，如T1期伴高危/极高危因素）是否需清扫仍是争议焦点。其核心矛盾在于： 1. 理论需求：淋巴结转移是预后不良标志，但影像学阴性患者的隐匿转移率仅约5%-10%； 2. 实践风险：清扫可能破坏局部免疫微环境，增加复发风险，甚至影响后续免疫治疗疗效。 中国实践：吕强教授团队的关键证据 吕强教授团队通过单中心前瞻性研究
Show notes
SWOG S1011研究结果是否将改变MIBC根治术中淋巴结清扫范围的临床实践？
Apr 15, 20269mEp. 10
导语： 在泌尿外科领域，肌层浸润性膀胱癌（MIBC）的治疗一直是备受关注的焦点。根治性膀胱切除术作为 MIBC 的主要治疗手段，其手术范围的确定对于患者的预后至关重要。而淋巴结清扫作为手术中的关键环节，其清扫范围一直是临床实践中的争议点。 今天，我们聚焦于 2024 年发表在 NEJM 杂志上的 SWOG S1011 研究，这项从 2001 年至 2017 年、纳入 658 名患者的大型前瞻性随机对照研究，无疑为我们提供了重要的参考依据
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