Related Experiment Video
Updated: Mar 29, 2026
Induction of Invasive Transitional Cell Bladder Carcinoma in Immune Intact Human MUC1 Transgenic Mice: A Model for Immunotherapy Development
Published on: October 30, 2013
Bladder Preservation with Concurrent Chemoradiotherapy Following Complete Response to Induction Systemic Therapy in
Georgios Nikiforos Ntoumas1, Andromachi Kougioumtzopoulou1, Dimitra Desse1
1Department of Clinical Radiation Oncology, Medical School, ATTIKON University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece.
Background/Objectives:
The standard surgical treatment of muscle-invasive bladder cancer (MIBC) comprises neoadjuvant systemic therapy followed by radical cystectomy (RC). However, a notable number of patients achieve a favorable response to neoadjuvant systemic therapy, a finding associated with improved outcomes, and questioning the necessity of RC in this subset of patients. The objective of this review is to summarize the available evidence regarding the feasibility, efficacy and toxicity of bladder-preserving chemoradiotherapy (CRT) following clinical response (CR) to neoadjuvant systemic therapy in patients with MIBC.
Methods:
A literature search was performed using the PubMed database to identify studies evaluating the use of CRT for bladder preservation in MIBC patients with CR following neoadjuvant therapy.
Results:
Clinical complete response (cCR) rates to neoadjuvant systemic treatment ranged from 31% to 87.5%, with subsequent CRT enabling 50-97% of responders to retain their bladder. Long-term outcomes were favorable for cCR patients, with 3- to 5-year overall survival (OS) ranging from 65% to 89%, disease-free survival (DFS) of 64-86%, and bladder-intact survival up to 80%. Achievement of cCR, T2 tumor stage, absence of concomitant carcinoma in situ or hydronephrosis, and complete transurethral resection of the bladder tumor (TURBT) were prognostic factors for improved oncologic outcomes. Treatment-related toxicity was generally acceptable, concerning mainly hematological and gastrointestinal events, while severe late toxicity was uncommon.
Conclusions:
Bladder-preserving CRT is a promising, effective, and well-tolerated option for MIBC patients achieving CR to neoadjuvant systemic therapy. While further prospective validation and longer follow-up are required before it can universally replace radical cystectomy in this subset of patients, advances in neoadjuvant treatments, imaging and molecular biomarkers may improve response assessment and patient selection for bladder preservation.
