523
ONKOLOGIE3418040010760120167227269329388409453
/8408040010731
Onkologie.9168040010761110147195214263313331375390
2025;19(2):84-901326804001074487128172185223260284327349364408454483527572
/19438040010731
www.onkologiecs.cz48658040010765133201214262311348396415464514532576617652669709748
841828020012657116
HLAVNÍ341200012670127198263336370
TÉMA733200012657114204274
Radioterapie34136001063375115132173203236271313348365397
jako7533600106226197136
orgán90436001063975114154196
záchovný111536001063172106147188225266303
postup143436001063374107139180215
v1665360010636
léčbě17173600106296196132164
invazivního18973600106155695131165183221262280321362
karcinomu227436001063476111146163204245299340
močového262936001065293128167204236277318
měchýře296336001065183118159196232265
Radioterapie34092002981422684094746106978229121036117812421367
jako1755920029870196324457
orgán22619200298138228367493631
záchovný294192002981122403464856227448841003
postup39929200298144281383470608750
v47919200298127
léčbě4967920029866191299442567
invazivního340118002986620432545056162675289295610991236
karcinomu1624118002981302573464535176567939971135
močového2808118002982063434515867088299691106
měchýře396211800298207332440580699790916
Martin3401580013793152194236267331
Palkovský,6931580013764121151211273329376436497521
Renata12361580013766124189246286345
Soumarová16031580013760123187282340382446502560
Onkologická3401740013376137188247273333395420469519573
klinika936174001335279104164189240293
3.1253174001335678
LF13541740013352105
UK14821740013371130
a16361740013353
FNKV,17121740013354124183248264
Praha1999174001335993146207259
Invazivní340225001212481130181226252302360386
karcinom758225001214798133179204262319405
močového11952250012183141188244293345403460
měchýře16872250012184136184241289324376
(MIBC)20952250012129110136192252284
je2411225001212577
tradičně2520225001213468119178203250307359
léčen2912225001212376123175232
neoadjuvantní31772250012155108166217275301358409459517551608634
chemoterapií3402390012145103155242299334386421472531557583
(NAC)955239001212996159217249
a12362390012149
radikální1317239001213384143169218269295353378
cystektomií1728239001214597138175226276314371457482508
(RACE).2268239001212984150208258289310
Přestože2611239001215387139181217274318370
trimodální301423900121336894180237297348373431456
terapie3503239001213385120171230256308
(TMT),340253001212985170224258280
zahrnující654253001214497157193253311338365413439
maximální11272530012186138189216304356382442468
transuretrální1629253001213470122182224282318372409445498524583609
resekci2273253001213387130184235283309
(TUR)2616253001212985155213244
a28942530012149
chemoradioterapii29772530012146105160248307344396457483542579632668720781808834
(CHRT),340267001212885151206258291311
přináší672267001215791116172222262287
srovnatelné980267001213973129178235284318369395451503
výsledky,15042670012148100141166217276324375393
není19182670012156107164189
dosud21282670012156113153209267
považována24162670012157114163212257313361411468517
za2954267001214394
standardní3069267001214075125182240289323380437462
léčbu.3552267001212375122180237259
Tato340281001215093128184
práce555281001215792143189240
analyzuje8272810012148105155181230277334360412
výsledky12712810012148100142167220279327380
recentních1682281001213385132183241275333358404461
studií2175281001213975132191216241
a24472810012149
doporučení25272810012156113173230265323370421478503
týkajících3062281001213385134185211236283308354411
se3505281001213992
TMT36282810012150132183
v3402950012148
léčbě413295001212476124182235
MIBC.6732950012181107163223248
Retrospektivní3403090012153103137171225265321373420457480529585609
analýzy9683090012147103151175223268318
naznačují,13063090012154102146202250295350374398419
že1744309001214292
TMT18563090012148128178
dosahuje20533090012155111150199255310334384
podobného24573090012156112169224281337388444499
přežití2975309001215689139183207240264
bez32583090012156108151
metastáz34293090012181132166215255289338382
(MFS)3403230012128109160209239
a6063230012148
přežití682323001215791143188214249274
bez9833230012157110156
nemoci11663230012156108194251298323
(DFS)1517323001212896147196226
jako1770323001212474123179
NAC19763230012166128186
s21893230012140
RACE.22563230012154119177227251
Neexistence25353230012165118171220246287323374432479530
přímého3092323001215792117203255313370
srovnání3490323001213973130179237287340338001215581
TMT4523380012150132183
a6673380012148
NAC7473380012166129186
s9653380012139
RACE10363380012154119177227
však1295338001214889140189
omezuje15153380012155141193239296322374
implementaci19213380012123108167193245331384441476526573598
TMT25513380012150132183
jako2766338001212474123178
standardní2976338001214076127184242292327385442467
metody34753380012184136172228287336
léčby.340352001212476124182230249
I6173520012124
přesto670352001215792143185221277
nová9763520012155112161212
doporučení12163520012157114173231266323370421479504
uznávají17493520012155100157207256306332357
TMT21353520012150131183
jako2347352001212474123178
rovnocennou2554352001213389138197254301352410467524581
alternativu3164352001214874109160195253303337362413470
pro3663352001215792148
pacienty3403660012157108154179232289324375
s7433660012140
omezenou8113660012155140193238290348405462
způsobilostí13013660012143102159200257316342367424466501526
k18553660012147
NAC19303660012166128186
nebo21443660012155108167225
RACE23963660012154119177227
nebo26513660012155108167225
preferující2904366001215792143175227262320345370417442
zachování3374366001214394141198255305355412437
močového3403800012183141188244293344402459
měchýře.8253800012184136184241289324376398
Nové12493800012166124173224
strategie1500380001213975110160195246305330382
zahrnující1909380001214394152186244301326351398423
imunoterapii23593800012123108165222279314366400451510535560
ukazují29463800012155104155200258283308
potenciál32813800012157115150201259306331381406
ke3714380001214797
zlepšení340394001214368121180221273331356
výsledků.7213940012149101143168220280328386408
Závěrem3404080012156106153203236287372
lze741408001212367118
říci,887408001213357103126147
že1063408001214394
TMT11864080012150131182
představuje1397408001215790141199239273323370427451502
účinný19284080012156101125181237283
orgán2240408001215689146195251
záchovný2520408001214393139195251299356402
postup29514080012157114154189244302
u32824080012156
vybraných33674080012148100158192241297343388444
pacientů3404220012157106150173224279312366
s7254220012139
MIBC,7834220012180104159217239
avšak1040422001214995134183230
volba12884220012148102126183232
léčebné1538422001212474120168226281332
strategie1888422001214074106155187236293316367
vyžaduje2273422001214899144193250305328379
individuální2670422001212379135158207231287342390413468491
přístup3180422001215789113152185240297
a34954220012149
multidisciplinární35624220012183138162195218340436001215679118163186243267290345393426481505
spolupráci.866436001213996152176230287320369414436457
Klíčová340454001246190118163220272325
slova:686454001244371130182235260
invazivní968454001212379125173217240289345368
karcinom1357454001214796129173196251306390
močového17684540012184139185238285334390445
měchýře,22354540012183134179234280313363383
radioterapie,2639454001213382138161216249298331380436460510530
chemoradioterapie,3191454001214499150233289322370427450505538587340468001213381138162212232
trimodální59346800121336589172227285333356411434
terapie,1048468001213383116164221244295315
orgán1384468001215588143191246
záchovná1652468001214292137192247294350398
léčba.2072468001212374119176224246
Radiotherapy3404990012459113173201259296356409448500560612
as972499001245396
an10884990012453112
organ-preserving1220499001245896156209268301362401454498552591646674733792
approach20324990012453113173212270323368428
in2480499001242786
treating2586499001243776130183220248307366
muscle-invasive29724990012486144188234262316350379438490543586614667719
bladder340513001246088141201261314353
cancer714513001244598157202255294
Muscle-invasive3405310012180136175220243293326351406452501540563611660
bladder1024531001215781129185242292325
cancer1373531001214493148193242275
(MIBC)16725310012128107131185243273
has19685310012156104143
traditionally2134531001213366114171194227250305361409432455503
been26605310012157108159215
treated2899531001213365115163196245302
with3225531001217397130185
neoadjuvant34345310012155106161210267290345340545001214896151184
chemotherapy5415450012145100150233288321376426459507564610
(NAC)1169545001212893153208238
and14245450012149104160
radical1602545001213281137160205253277
cystectomy1896545001214594134167217262297351434480
(RACE).2394545001212881144199247275294
Although2706545001216184117172227282338393
trimodal311654500121336689172227284332355
therapy3489545001213388138171219276322
(TMT),340559001212880159207238256
involving613559001212478124177200248271326381
maximal10115590012183131177200283330353
transurethral1381559001213365113167205259291340373427459507530
resection1928559001213281120170215250272327382
(TUR)2327559001212880144197224
and25685590012148103158
chemoradiotherapy2744559001214498148231285317365421444498530585634667714770816
(CRT),3577559001212883135185216234
yields340573001214872123147205244
comparable613573001214599184241291324373431455506
results,1148573001213383123179202236277298
it1475573001212457
is1561573001212463
not16535730012156112145
yet1827573001214797131
considered19875730012145100156195219276327360411469
standard2485573001214074123179237285318375
treatment.2889573001213366117166199283334390423445
This33635730012150107130170
paper35625730012157106164216249
analyses3405870012148103151175222262312352
the716587001213388139
results879587001213383122177200233274
of1177587001215584
recent1285587001213383128177233265
studies1575587001213973128185208258298
and18975870012148104160
recommendations2082587001213282128181265348399455511559592615670725764
concerning2871587001214498154199248281336359415471
TMT33665870012150130179
in3570587001212378
the3673587001213388138
treatment340601001213366115163196279330385418
of779601001215584
MIBC.8846010012181105159217240
Retrospective3406150012154104138170225264321372417453476524573
analyses9326150012148103151174222261312351
suggest1302615001213994150206256296330
that1650615001213388136169
TMT18376150012150130179
achieves2035615001214893148171221269318357
metastasis-free24116150012183134167216255289338377400438469499532582633
survival3062615001214094127178202250299322
(MFS)34026150012129107156204231
and36516150012149104160
disease-free340629001215678116166213252301334363396445495
survival852629001213993125175198246293316
(DFS)1185629001212893141188214
rates1416629001213381112161200
similar1633629001213961143166189236267
to1918629001213285
those2021629001213287141179229
obtained22676290012154111143191214268317374
by26586290012156102
NAC27776290012165125179
with2974629001217296128182
RACE.31736290012154116170218239
However,34296290012165120191240287335367383
the340644001213388139
lack502644001212472117163
of689644001215584
direct797644001215679112162207243
comparison1063644001214599182239288320344383438494
of1581644001215483
TMT16886440012150130179
and18916440012148104160
NAC20756440012166127182
plus2281644001215781136175
RACE24796440012154117173221
limits2724644001212346130153186226
the2974644001213389139
implementation31376440012123106163187237321372427460508541564619675
of340658001215584
TMT4516580012150129179
as657658001214887
a7716580012148
standard846658001214074122178234282315371
treatment1244658001213365115163196279330385418
method.16896580012183133167222277334355
Nevertheless,20716580012166117164213246282337388412462502541562
new26606580012155106179
recommendations2866658001213382128182265349399455511559592615670726764
recognise36576580012133831283406720012155112167190229279
TMT6476720012149129179
as854672001214887
an9686720012149104
equally10996720012151108163211234257304
valid1431672001214897120143200
alternative1658672001214872105154187243291323346395444
for2129672001212984117
patients22746720012157106138161211267299340
with2641672001217498131186
restricted2855672001213282122155188212256292341398
eligibility328167200121507497153176233256280303336385
for3694672001212984117
NAC3406860012165125180
or538686001215487
RACE,6426860012153116171218239
or898686001215587
for1003686001212983115
those1136686001213387142180230
who13846860012173128182
prefer1584686001215689138167217249
bladder1851686001215680127183239289321
preservation.2190686001215689138177227259310357389412466521542
Novel27506860012165120166215238
strategies3006686001213972104152184233289312362401
including3424686001212378122145199255278332388
immunotherapy3407000012123107190245300355388443493526575632678
show1039700001214095150223
potential12837000012157113146195251283306354377
for1681700001212984117
improved18207000012123106163196250298347404
outcomes.22457000012155110143187241324375415436
In340714001212479
conclusion,447714001214599154199223277316339394450471
TMT9467140012149129179
is1153714001212362
an12437140012148103
effective1374714001215080113163209244267315364
organ-preserving1766714001215588144192247279337370420460510543594618673729
procedure2523714001215790145190239297351384434
in2985714001212378
selected3091714001214090114165210246295352
patients34717140012157106138161212267300340
with340728001217497130186
MIBC;5537280012181105159217238
however,8197280012155111183233280330362378
the1225728001213389139
choice13927280012145100155178223272
of1692728001215584
treatment1804728001213365115163196279330385418
strategy2249728001214074106155187237293341
requires2618728001213383140195218250300340
a29867280012148
tailored3062728001213382105128183216266323
approach34137280012148105162195249298343398
and3407420012148103160
multidisciplinary5217420012184138162195218274297336381404461485508563611644694
collaboration.1236742001214599123146194250306339388420443498554575
Key3407600012462113165
words:5327600012476133171232276302
muscle-invasive8627600012184138178223246297330354410456505544567616665
bladder1555760001215781129186243293326
cancer,1910760001214493149194243276292
radiotherapy,2230760001213382138162217250305356389437494541557
chemoradiotherapy,28157600012145100151234290323371428451507539595645678727784830846
trimodal3690760001213365893407740012183139196244267
therapy,628774001213489139172221277324340
organ-preserving989774001215588143191247279337370420459510542594617673729
treatment.1739774001213366115163196279330385418439
DECLARATIONS:4068227008648871301662142563043393604124625014570228008514
Declaration406824100874987120141179206244271291333375
of445724100874066
originality:45372410087406888130150192230251271298337356
The406825200853473109
manuscript418825200855891130168195227249266306329
is452825200851744
original45832520085386178117133172205222
and481625200853472112
has49392520085387299
not50502520085387699
been516125200853975110149
published532225200853977117134150177216251291
or406826300853862
submitted414526300852867108167184208234269310
elsewhere.44702630085355381117169209245269305320
Ethical406827700873764107127160198218
principles43002770087427090132165185228249287319
compliance:463327700873173134177197218256298330368387
The406828800853678116
authors420528800853475100142183208238
attest44642880085356087124153179
that466428800852465101126
their481128800852465103121146
study49782880085295595138173
was517328800855389118
approved531228800853577120145186221258301
by406829900854073
the41582990085236399
local42742990085175689124141
Ethical44322990085345898115147182199
Committee464829900854179139198215239265300337
and500229900853373113
is513229900851745
in519429900851656
compliance526729900853169129169187204239278311346
with40683100085537298140
human423631000854081143180221
studies44863100085285596139157195226
and474031000853577119
animal48883100085347695156193212
welfare512831000855391110133170196234
regulations53903100085236110414516420140683210085234080120148
of423532100853960
the43153210085236399
authors’44343210085347397136176200229244
institutions46983210085165684109126150189213231270310338
as505632100853462
well513832100855187104122
as527932100853462
with53613210085526993133
the55143210085236299
World406833200856099124142184
Medical427333200855795137155188224242
Association453533200854474104144178196231256273314355
Declaration491133200854785119136172196232257274315356
of528833200853961
Helsinki537033200854684102131149189224243
on406834300853878
Ethical41653430085355898115147182199
Principles43833430085376178117150167207225261290
for46923430085205983
Medical479434300855693134151183218235
Research504834300853874102139173197229268
Involving53353430085175690128146181198238278
Human406835400854685145179219
Subjects430735400853474114132168201227256
adopted458335400853474114155179215256
by485835400854074
the49523540085236399
18th507135400853669514135500501437
WMA5198354008559116160
General537835400854582122158182217235
Assembly406836500854475105143204247266302
in439336500851758
Helsinki,447436500854785104134152193228248264
Finland,47613650085355394113149190232249
in503336500851758
June511536500852667109147
1964,528536500853771110150166
with54743650085537297139
subsequent406837600852867107136172213252288328352
amendments,443737600853493130169210269305345369398414
as486837600853462
well494837600855287105122
as508837600853362
with51673760085526993133
the53183760085236298
ICMJE543437600851759116143179
Recommendations406838700853977112153216278317359402439465483525568598
for46973870085226389
the481838700852466104
Conduct,495438700854283125168210245272290
Reporting,527538700853978121163189217236278321338
Editing,40683980085347491115132172212227
and430839800853373113
Publication443439800853776117134151183218242259298338
of478539800853859
Scholarly485739800853467106146163198221239273
Work514239800856097121155
in531039800851656
Medical537839800855693134151183218235
Journals,406840900852666105129169204221249265
updated435340900853980121155179215256
in462940900851656
December470540900854683116151211252289313
2018,503740900853673107140156
including52134090085165689106145186203243283
patient55164090085407540684200085234076116140
consent422242000853270110138174214238
where447542000855191127151187
appropriate.467742000853474115139178219243260295318354369
Conflict406843400874282124149171191223251
of433443400874065
interest44134340087196288126154192224251
and467843400873779122
financial48144340087244587125167200220258279
disclosures:51074340087416293126147188220261289327359378
None.406844500854686126162177
Funding/Support:406845900873777119162183225267291329371414457499526554574
None.406847000854686126162177
Cit.4068714008541588297
zkr:41807140085306489105
Onkologie.429971400864991127167186227268287324342
2025;19(2):84-90465571400863876113151167203238260297317334373413438476515
https://doi.org/10.36290/xon.2025.018406872500853962881291571721982194284725008641811004385725008514547811714345287250086387390130169206244283307342382423441481519556594611650686721
Článek40687360085415892132168202
přijat4285736008539638198132156
redakcí:445673600852359100134168199216231
13.47017360085366983
1.479973600853648
2025486273600853672107144
Článek40687470085415892132168202
přijat4285747008539638198132156
k4456747008533
tisku:45047470085234068101141156
10.46757470085366984
2.477474700853652
2025484174700853672107143
MUDr.4068766008759108158186202
Martin428476600875998126154174216
Palkovský45157660087407898137178215246285325
martin.palkovsky@fnkv.cz406877800855893117143160199215256291308342380414443476512564586626660696708741773