X-ray endovascular surgery in treatment of locally advanced bladder cancer and its complications: history of development and study of surgical tactics, modern capabilities, limitations and development prospects

INTRODUCTION: Over the past decade, the number of patients with bladder cancer (BC) has been growing worldwide. In Europe and North America, BC is the fourth most common cause of cancer in men and the second most common malignant tumor of the genitourinary system. In Russia, BC ranks 7^th among cancers in men and 17^th in women. It is important to note that these patients, with the mean age ≥70 years, often have a severe concomitant pathology. The predominant histological form of BC is transitional cell carcinoma accounting for 90% of cases.

AIM: Based on the literature data analysis, to determine the prospects of intra-arterial embolization and chemoembolization of tumor-supplying vessels for the treatment of bladder cancer.

The information search was conducted in eLibrary, PubMed, Scopus, Google Patent, Google Scholar, ResearchGate databases from May to June 2024 without restrictions on the type and time of publication. The following keywords were used: muscle-invasive bladder cancer, hematuria, bladder malignancy, interventional oncology, embolization, and vesical artery chemoembolization. The primary treatment for BC is surgical intervention, however, recently, of special attention have been interventional methods of local treatment. Chemoembolization is an innovative approach combining local therapy and embolization of the tumor-supplying vessels. This allows for the delivery of high concentrations of chemotherapeutic drugs directly to the tumor, minimizing systemic side effects. This is especially relevant when radical tumor resection is not possible, or as a variant of emergency intervention to stop bleeding.

CONCLUSION: Having reviewed the works, it can be concluded that intra-arterial embolization holds promise for the treatment of such a threatening BC complication as hematuria. In addition, the interventional tactics has shown encouraging results in the treatment of locally advanced BC, as well as the potential for palliative treatment of tumors of this location. However, due to the paucity of data, this approach requires further clinical investigation.