Invasive bladder cancer: the role of bladder preserving therapy

Area of Science:

• Uro-oncology
• Cancer therapy research
• Clinical outcomes analysis

Background:

• Invasive bladder cancer necessitates aggressive treatment, often radical cystectomy.
• Organ preservation strategies are explored to improve patient quality of life.
• Multimodality therapy presents a potential alternative to cystectomy.

Purpose of the Study:

• To evaluate outcomes of multimodality therapy with organ preservation in invasive bladder cancer.
• To assess organ preservation as an alternative to radical cystectomy in select cases.
• To compare reported results of organ-preserving strategies with radical cystectomy outcomes.

Main Methods:

• Systematic review of articles published between 1974 and 2004.
• Focus on multimodality therapy (transurethral resection of the bladder tumor [TURBT] + chemoradiation) for invasive bladder cancer.
• Comparative analysis of organ preservation outcomes against radical cystectomy data.

Main Results:

• Multimodality therapy with bladder preservation yields 36%-48% 5-year survival rates.
• Overall survival rates for organ preservation range from 48% to 63%.
• Significant morbidity, mortality, and need for salvage cystectomy (34%-45%) or repeat TURBT (28%) are associated with this approach.

Conclusions:

• Organ preservation in invasive bladder cancer using multimodality therapy can yield acceptable results in specific situations.
• Close multidisciplinary team collaboration (urologist, radiotherapist, oncologist) is crucial for successful organ preservation.
• Radical cystectomy is still considered the gold standard treatment for invasive bladder cancer.