Organ preservation in muscle-invasive bladder cancer

While organ preservation with nonextirpative surgery, radiotherapy, and frequently, chemotherapy has become a favored strategy in the treatment of many cancers, bladder preservation for patients with invasive disease remains controversial. The standard treatment for muscle-invasive bladder cancer in the United States is still radical cystectomy with pelvic lymph node dissection. An alternative to cystectomy is multimodality bladder preservation with thorough transurethral resection, chemotherapy, and radiation therapy. This review will address issues raised by a multimodality approach for the treatment of invasive bladder cancer.