Abstract
The concept of organ-preserving therapies is a trend in modern oncology, and several tumour types are now treated in this fashion. Trimodality therapy consisting of as thorough a transurethral resection of the bladder tumour as is judged safe, followed by concomitant chemoradiation therapy, is emerging as an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer. Long-term data from multiple institutional and cooperative group studies have shown that this approach is safe and effective and that it provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that for modern radical cystectomy.
Highlights
Urinary bladder cancer is the ninth most frequent cancer worldwide, accounting for 2.1% of all cancer deaths 1
We review the most relevant literature on radiochemotherapy treatments for infiltrative transitional-cell bladder carcinoma, and we show evidence that bladder preservation is a safe approach—as effective as the current “gold standard”—that should be considered as an attractive therapeutic option for selected patients
Radical cystectomy is considered by most urologists to be the “gold standard” treatment for muscleinvasive transitional-cell carcinoma of the bladder
Summary
Urinary bladder cancer is the ninth most frequent cancer worldwide, accounting for 2.1% of all cancer deaths 1. Most of these cancers (65%–70%) are superficial at presentation and are typically managed conservatively. Bladder tumours are staged according to the depth of invasion. The most commonly accepted standard local treatment for muscle-infiltrating tumours remains radical cystectomy with pelvic lymph node dissection 2. Since the late 1980s, several centers have used bladder-preserving strategies, combining radiotherapy (rt) and chemotherapy as an alternative to radical cystectomy [3,4,5,6,7,8,9]
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