Editing Muscle-Invasive Bladder Cancer (section)

====Patient selection====
*'''<span style="color:#ff0000">Indications[https://pubmed.ncbi.nlm.nih.gov/28456635/ ★]</span>'''
*#'''<span style="color:#ff0000">Patients with newly diagnosed non-metastatic MIBC who desire to retain their bladder</span>'''
*#'''<span style="color:#ff0000">Patients with significant comorbidities for whom radical cystectomy is not a treatment option, clinicians should offer bladder</span>''' 
*#*'''Overall, bladder preserving therapy has been associated with decreased survival compared to RC'''
*#**'''Patients who are deemed “medically fit” to undergo cystectomy should be offered cystectomy as the standard of care'''
*#*Studies that support bladder preserving strategies, as a general rule, have highly select patient populations
*#*Bladder preservation should be undertaken with the goal of curative therapy and to maintain a functionally intact bladder
*'''<span style="color:#ff0000">Ideal characteristics for bladder preservation (4):[https://pubmed.ncbi.nlm.nih.gov/28456635/ ★]</span>'''
*# '''<span style="color:#ff0000">Unifocal tumor</span>'''
*#'''<span style="color:#ff0000">No CIS</span>'''
*#'''<span style="color:#ff0000">No evidence of hydronephrosis</span>'''
*# '''<span style="color:#ff0000">A tumor that can be completely transurethrally resected</span>'''
*'''Contraindications'''
**'''Relative'''
**#'''Large tumors unable to be resected by TURBT'''
**#'''Multifocal CIS'''
**#'''T3/T4 tumors,'''
**#'''Presence of hydronephrosis'''
**#Non-urothelial carcinoma
**##Patients with adenocarcinomas, sarcomas, and squamous cell carcinomas have not been included in prospective studies of radiation-based bladder preservation
**'''Unknown how variant histology affects outcomes associated with multi-modal bladder preserving therapy'''
*'''In patients under consideration for bladder preserving therapy, maximal debulking transurethral resection of bladder tumor and assessment of multifocal disease/carcinoma in situ should be performed'''
**In multiple prospective trials, the ability to resect all tumor predicted the best response to bladder preserving therapies.
**'''Random biopsies may help ensure that there is no associated CIS.'''