Invasive bladder cancer: the role of bladder preserving therapy

To evaluate the reported outcomes of multimodality therapy with organ preservation in invasive bladder cancer and assess it as an alternative for radical cystectomy in selected cases.

All the articles on multimodality therapy with organ preservation in invasive bladder cancer, published from 1974 to 2004, were reviewed and the results were compared with the outcome of radical cystectomy in cases with invasive bladder cancer.

Multimodality therapy is transurethral resection of the bladder tumor (TURBT) combined with chemoradiation therapy. It yields a 36% to 48% 5-year survival rate, when the bladder is preserved, and an overall rate of 48% to 63%. This method takes a long time for treatment and is accompanied by significant morbidity and mortality. Cystectomy will be required in 34% to 45% of the patients, during the treatment course, and in 28%, repeat TURBT will be performed due to recurrence of superficial tumors.

Organ preserving in multimodality therapy of invasive bladder cancer can have acceptable results in some special situation, provided that a close cooperation between urologist, radiotherapist, and oncologist exists. However, radical cystectomy is still considered the standard treatment for invasive bladder cancer.