Organ-sparing treatment of bladder cancer: an innovative approach

Muscle-invasive carcinoma of the urinary bladder is a highly malignant disease with a rapid doubling time and a propensity for distant metastasis. Although radical cystectomy has been the treatment of choice in the United States, limited tumor resection followed by chemotherapy and radiation therapy, with preservation of a normally functioning bladder, is an alternative approach of significant usefulness. In carefully selected patients, such treatment offers a good chance of long-term cure and survival equal to that associated with cystectomy. This combined-modality approach remains investigational and requires a multidisciplinary team including a urologic surgeon, a radiation oncologist and a medical oncologist.