Organ-saving treatment of invasive bladder cancer

Abstract

The review describes the modern approaches to open and endoscopic surgery, chemo- and radiotherapy in organ-saving treatment of invasive bladder cancer. Bladder cancer nowadays ranks the second among urological malignancies. Incidence of bladder cancer in Russia has increased by 58.6% over the past 10 years, with the share of invasive tumors reaching 30%. According to the European Association of Urology guidelines, the radical cystectomy with ureterocolonic diversion is the standard treatment of muscle-invasive bladder cancer. However, the extensive surgical trauma, comorbidities and exhaustion of patients, disability and social adaptation failure as well as the high mortality rate restrict the use of cystectomy. Thereby, taking into account the dynamic development of chemo- and radiotherapy allowing to reduce the recurrence rate, more and more experts are inclined to use organ-saving treatment of invasive bladder cancer. Organ-saving treatment has several advantages: it is less complicated and costly, preserves sexual function, decreases the risk of kidney damage and provides a good quality of life. Still, scanty publications are comparing results of cystectomy and organ-saving treatments of invasive bladder cancer, causing controversial opinions and highlighting the need for further studies.