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Trimodality bladder preservation therapy for muscle-invasive bladder cancer
Ronald C Chen1, William U Shipley, Jason A Efstathiou
1From the aDepartment of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and bDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Trimodality bladder preservation therapy offers a curative option for muscle-invasive bladder cancer (MIBC), achieving survival rates comparable to cystectomy while preserving the native bladder for most patients.
Area of Science:
- Urology
- Oncology
Background:
- Muscle-invasive bladder cancer (MIBC) treatments are underutilized, particularly in elderly patients.
- Radical cystectomy is a standard treatment but involves significant morbidity.
Purpose of the Study:
- To evaluate trimodality bladder preservation therapy (trimo-BPT) as an alternative to radical cystectomy for MIBC.
- To highlight the efficacy and quality of life outcomes associated with trimo-BPT.
Main Methods:
- Review of prospective clinical trials and institutional series on trimo-BPT.
- Analysis of survival rates, bladder preservation rates, and quality of life in long-term survivors.
- Evaluation of salvage cystectomy outcomes for local recurrence.
Main Results:
- Trimo-BPT demonstrates 5-year overall survival rates of 48%-65%, comparable to cystectomy.
- 75%-80% of long-term survivors retain functional native bladders with good quality of life.
- Salvage cystectomy offers acceptable outcomes for local recurrence.
Conclusions:
- Trimo-BPT is an effective alternative to radical cystectomy for select MIBC patients.
- It is recognized by major urological guidelines as a viable bladder-sparing option.
- Future research may identify biomarkers for optimal patient selection.
