Bladder preservation in the treatment of muscle-invasive bladder cancer (MIBC): a review of the literature and a practical approach to therapy.
Bladder preservation therapies for muscle‑invasive bladder cancer (MIBC) have been developed to address the needs of patients with severe medical comorbidities or limited disease who wish to avoid aggressive surgery.
Bladder preservation therapies for muscle‑invasive bladder cancer (MIBC) have been developed to address the needs of patients with severe comorbidities or limited disease who wish to avoid radical cystectomy. The most strongly supported approach is trimodal therapy consisting of maximal transurethral resection followed by chemoradiotherapy. While outcomes are poorer for patients unfit for surgery, bladder‑preservation options still offer curative potential. This comprehensive review outlines the evidence base and a practical decision tree to aid urologists in selecting appropriate therapy. Prospective trials comparing these regimens to radical cystectomy are needed to better define their role in MIBC treatment.
Bladder preservation offers a less morbid alternative to radical cystectomy, potentially maintaining bladder function for selected patients, while acknowledging that clinical evidence remains limited and comparative trials are warranted.
Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.