Myths about bladder preservation in muscle-invasive bladder cancer
AffiliationDepartment of Clinical Oncology, The Cambridge University Hospitals NHS Foundation trust
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AbstractRadical cystectomy is long considered as the "gold standard" in the management of localized muscle-invasive bladder cancer (MIBC), and curative intent radiotherapy is relegated to those with either inoperable tumors or with multiple co-morbidities precluding surgery. This is despite a large volume of data showing equal survival between the two modalities of treatment in this setting. In this work we seek to dispel some common myths surrounding curative intent radiotherapy as part of a bladder preservation strategy in MIBC. Baseless claims of inferior outcomes and perceived contraindications for bladder preservation are debunked along with unfounded doubts relating to hypofractionation. Finally, we caution against using response to neoadjuvant chemotherapy as a predictive biomarker for treatment selection and conclude by recommending that trimodality bladder preservation be offered as a therapeutic option that is in clinical equipoise with radical cystectomy.
CitationElumalai T, Joseph N, Choudhury A. Myths About Bladder Preservation in Muscle-Invasive Bladder Cancer. Seminars in radiation oncology. 2023 Jan;33(1):56-61. PubMed PMID: 36517194. Epub 2022/12/15. eng.
JournalSeminars in Radiation Oncology
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