2025版EAU肌层浸润性和转移性膀胱癌指南更新解读OA

The 2025 European Association of Urology(EAU)guidelines on muscle-invasive and metastatic bladder cancer(MIBC)have systematically optimized the diagnostic and therapeutic flows for MIBC.In terms of molecular biomarkers,the guidelines have introduced a new recommendation for the use of fibroblast growth factor receptor 3(FGFR3)alterations to select patients with unresectable or metastatic urothelial carcinoma for treatment with erdafitinib.Significant modifications have been made to the recommendations regarding perioperative radiotherapy.For patients with pathological T3b to T4 diseases,lymph node positivity,or positive surgical margin after radical cystectomy,a weak recommendation for adjuvant radiotherapy has been proposed.In female patients,the guidelines have a higher recommendation level for the implementation of sexual-preserving techniques in eligible cases.The guidelines emphasize the strong correlation between the surgical volume of radical cystectomy in hospitals and patient outcomes,recommending that centers performing radical cystectomy should conduct more than 20 cases annually.Additionally,the guidelines have provided comprehensive updates on adjuvant therapy,treatment of metastatic disease,and follow-up strategies.These updates offer more practical guidance for clinical decision-making and provide substantial support for improving patient outcomes.