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Bladder Preservation Strategies for Muscle-Invasive Urothelial Carcinoma of the Bladder

April-June 2014, Volume 01, Number 2
Rafael Morales-Barrera, Cristina Suárez, Claudia Valverde, Glenda García-Chacón, Carles Raventos, Juan María Bastaros, Juan Morote, Xavier Maldonado and Joan Carles
Genitourinary, CNS Tumors, Sarcoma and Cancer of Unknown Primary Site Program, Department of Medical Oncology, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain

The standard of care for muscle-invasive bladder cancer is radical cystectomy with bilateral pelvic lymph node dissection. However, nowadays there is a tendency for organ preservation in selected cases of muscle-invasive bladder cancer. The triple-combined therapy consisting of a transurethral resection followed by concomitant chemoradiotherapy results in comparable outcomes to radical cystectomy. Clinical criteria in determining patients for organ preservation includes: small tumor size (< 2 cm), absence of urethral obstruction, no evidence of pelvis lymph node metastases, and absence of carcinoma in situ. Bladder conservation therapy could be offered to selected patients as one alternative to radical cystectomy.

Key words:
Radical cystectomy. Trimodality treatment, Transurethral resection. Bladder cancer. Bladder preservation.
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