关于盆腔淋巴结阳性但非转移的膀胱癌患者的最佳治疗方案，目前数据有限。越来越多的数据表明，这是一种明显有别于只限于膀胱内的肌层浸润膀胱癌和晚期转移性膀胱癌之间的病理生理实体。指南和分期系统已经正式将盆腔淋巴结阳性膀胱癌的管理独特考量规范化。然而，仍缺乏确切的治疗标准。治疗选择包括仅进行全身治疗、新辅助化疗后进行根除性膀胱切除术，或膀胱保存的三重疗法。此外，正在进行的研究旨在确定将免疫治疗纳入这些治疗范式的益处。本综述文章，我们将讨论盆腔淋巴结阳性膀胱癌患者管理的关键考虑因素。

There are limited data regarding the optimal management of patients with pelvic node-positive, but non-metastatic, bladder cancer. Increasing data demonstrate that this is a distinct clinical entity with outcomes bridging between bladder-confined muscle-invasive bladder cancer and metastatic advanced bladder cancer. Guidelines and staging systems have formalized the need to incorporate the unique considerations of management of pelvic node-positive bladder cancer. However, there remains an absence of a definite standard of care. Treatment options include systemic therapy alone, neoadjuvant chemotherapy followed by radical cystectomy, or bladder-preserving trimodality therapy. Furthermore, ongoing studies aim to determine the benefit of incorporating immunotherapy into these treatment paradigms. In this review article, we will discuss the key considerations for management of patients with pelvic node-positive bladder cancer.Published by Elsevier Inc.