The usual treatment for localized muscle-invasive bladder cancer is to remove the bladder. More conservative organ-preserving options have been held in reserve for patients who cannot undergo surgery.
The usual treatment for localized muscle-invasive bladder cancer is to remove the bladder. More conservative organ-preserving options have been held in reserve for patients who cannot undergo surgery.Conservative treatment should be offered to all such patients whether they are candidates for surgery or not, says a team led by Alexandre Zlotta, MD, PhD, a urologic oncologist at the University of Toronto, Canada.
"This article has gained a lot of traction in bladder cancer circles, and I think for good reason. What makes this study unique is that it attempts to perform an apples-to-apples comparison of the two study groups," saidThese are"indeed...important finding[s].
The team concludes that"trimodality therapy, in the setting of multidisciplinary shared decision making, should be offered to all suitable candidates with muscle-invasive bladder cancer and not only to patients with significant comorbidities for whom surgery is not an option...as an oncologically equivalent alternative to radical cystectomy in select patients."Commenting on the study, Sharma said that careful"patient selection for trimodality therapy [is] key.
Sharma's team is researching the pros and cons of trimodality therapy in comparison with radical cystectomy in various scenarios. Sharma said that In the meantime,"bladder cancer providers should continue to offer trimodality therapy to appropriately selected patients with MIBC who are motivated to preserve their bladder.", a urologic oncologist at the University of Michigan, Ann Arbor, was impressed by the findings.
Reichert added that he hopes that urology guidelines will revisit trimodality therapy"in light of this new data."With 1:3 matching in the study by Zlotta and colleagues, 282 trimodality patients were matched to 837 radical cystectomy patients.
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