De rol van circulerende tumorcellen bij het urotheelcarcinoom van de blaas

Patients with muscle-invasive urothelial cell carcinoma of the bladder have a 50 % chance to develop distant metastases despite curative local treatment. Reliable markers that predict the risk of developing metastases or that could be used to determine whether or not perioperative systemic treatment should be given are lacking. Circulating tumor cells (CTCs) are cancer cells that are present in the blood stream of patients with solid tumors and originate from tumor lesions that are present in the body. The enumeration of CTCs is an attractive option to assess the chance to develop distant metastases in individual patients. Here, we set out to review the most relevant literature to date regarding the clinical value of CTCs in bladder cancer. Moreover, the CirGuidance study is presented, which is the first interventional trial, which uses CTCs to guide treatment choices regarding the administration of neoadjuvant chemotherapy in patients with muscle-invasive urothelial cell carcinoma.