Partial Cystectomy for Muscle-Invasive Bladder Cancer

Area of Science:

• Urology
• Surgical Oncology
• Bladder Cancer Research

Background:

• Partial cystectomy is a bladder-sparing surgical option for select patients with muscle-invasive bladder cancer (MIBC), urachal adenocarcinoma, and diverticular bladder tumors.
• It offers advantages such as definitive pathology, accurate staging, avoidance of radiation therapy side effects, and preservation of salvage therapy options.

Purpose of the Study:

• To evaluate partial cystectomy as a surgical option for specific bladder tumors.
• To outline patient selection criteria, procedural considerations, and follow-up protocols for partial cystectomy.

Main Methods:

• Patient selection involves ruling out multifocal disease or carcinoma in situ (CIS) using CT urogram, prostatic urethral biopsy, mapping biopsies, or blue light cystoscopy.
• Ideal candidates are those with small, solitary MIBC in a resectable area with negative margins.
• Neoadjuvant systemic therapy is recommended prior to partial cystectomy, which can be performed via open or robotic approaches.

Main Results:

• Partial cystectomy demonstrates lower complication rates, shorter hospital stays, and better quality of life compared to radical cystectomy.
• Five-year survival rates include 39-67% recurrence-free survival, 62-84% cancer-specific survival, and 45-70% overall survival.

Conclusions:

• Partial cystectomy is a viable bladder-sparing treatment for selected bladder cancers.
• Rigorous patient selection and appropriate follow-up surveillance are crucial for optimal outcomes.