Bladder Sparing Approaches for Muscle-Invasive Bladder Cancers.
MetadataShow full item record
OPINION STATEMENT: Organ preservation has been increasingly utilised in the management of muscle-invasive bladder cancer. Multiple bladder preservation options exist, although the approach of maximal TURBT performed along with chemoradiation is the most favoured. Phase III trials have shown superiority of chemoradiotherapy compared to radiotherapy alone. Concurrent chemoradiotherapy gives local control outcomes comparable to those of radical surgery, but seemingly more superior when considering quality of life. Bladder-preserving techniques represent an alternative for patients who are unfit for cystectomy or decline major surgical intervention; however, these patients will need lifelong rigorous surveillance. It is important to emphasise to the patients opting for organ preservation the need for lifelong bladder surveillance as risk of recurrence remains even years after radical chemoradiotherapy treatment. No randomised control trials have yet directly compared radical cystectomy with bladder-preserving chemoradiation, leaving the age-old question of superiority of one modality over another unanswered. Radical cystectomy and chemoradiation, however, must be seen as complimentary treatments rather than competing treatments. Meticulous patient selection is vital in treatment modality selection with the success of recent trials within the field of bladder preservation only being possible through this application of meticulous selection criteria compared to previous decades. A multidisciplinary approach with radiation oncologists, medical oncologists, and urologists is needed to closely monitor patients who undergo bladder preservation in order to optimise outcomes.
Place of Publication
The following license files are associated with this item:
Showing items related by title, author, creator and subject.
Saki, Zakaria Issa (University of Plymouth, 2002)The purpose of this study was to investigate several biological markers that may predict the response of muscle invasive transitional cell carcinoma TCC of the bladder to radical radiotherapy. The specific markers chosen ...
Proapoptotic genes BAX and CD40L are predictors of survival in transitional cell carcinoma of the bladder. Hussain, SA; Ganesan, R; Hiller, L; Murray, PG; el-Magraby, MM; Young, L; James, ND (England, 2003-02-24)The purpose of the study was to investigate the effects of expression of a range of genes involved in apoptosis on outcome in bladder cancer. Immunohistochemistry was used to examine expression of BCL2, BAX, P53, CD40 and ...
Long-term results of a phase II study of synchronous chemoradiotherapy in advanced muscle invasive bladder cancer. Hussain, SA; Stocken, DD; Peake, DR; Glaholm, JG; Zarkar, A; Wallace, DMA; James, ND (England, 2004-06-01)We conducted a phase I/II study investigating synchronous chemoradiotherapy with mitomycin C and infusional 5-fluorouracil (5-FU) in muscle invasive bladder cancer. Early dose escalation results were previously published. ...