Muscle-Invasive Bladder Cancer: Difference between revisions

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==== Multi-modal/Trimodal bladder preserving therapy ====

*Most of the literature supporting multi-modal bladder preserving therapy with radical cystectomy is from one RCT and several observational studies that have compared EBRT with and without chemotherapy vs. radical cystectomy[https://pubmed.ncbi.nlm.nih.gov/38661067/]

*'''<span style="color:#ff0000">Includes (3):</span>'''

*#'''<span style="color:#ff0000">Maximal transurethral resection of bladder tumor</span>'''

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**Should be included when using multi-modal therapy with curative intent.

***Radiation with concurrent chemotherapy is superior to radiation alone.

**Several radiosensitizing chemotherapeutic agents have been shown safe and effective for trimodal bladder cancer therapy***'''Various regimens of neoadjuvant, concurrent and adjuvant cisplatin-based regimens (e.g., cisplatin alone, CMV, cisplatin + paclitaxel or cisplatin + gemcitabine) have been studied.'''

**Several radiosensitizing chemotherapeutic agents have been shown safe and effective for trimodal bladder cancer therapy

***'''Various regimens of neoadjuvant, concurrent and adjuvant cisplatin-based regimens (e.g., cisplatin alone, CMV, cisplatin + paclitaxel or cisplatin + gemcitabine) have been studied.'''

***Alternatives for cisplatin-ineligible patients include gemcitabine or 5-fluorouracil and mitomycin C.

***Carboplatin should not be used as a radiosensitizer unless there are contraindications to cisplatin, 5-FU, and gemcitabine.

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****Cystoscopy per high-risk NMIBC schedule

****Cross-sectional imaging of the abdomen and pelvis and chest imaging every 6 months for the first 2 years

**Unclear what proportion of patients who, having initially chosen bladder preservation, ultimately require cystectomy in a non-study setting.[https://pubmed.ncbi.nlm.nih.gov/38661067/]

=== Maximal TURBT/partial cystectomy ===

@@ Line 406: / Line 406: @@
 ==== Multi-modal/Trimodal bladder preserving therapy ====
+*Most of the literature supporting multi-modal bladder preserving therapy with radical cystectomy is from one RCT and several observational studies that have compared EBRT with and without chemotherapy vs. radical cystectomy[https://pubmed.ncbi.nlm.nih.gov/38661067/]
 *'''<span style="color:#ff0000">Includes (3):</span>'''
 *#'''<span style="color:#ff0000">Maximal transurethral resection of bladder tumor</span>'''
@@ Line 413: / Line 414: @@
 **Should be included when using multi-modal therapy with curative intent.
 ***Radiation with concurrent chemotherapy is superior to radiation alone.
-**Several radiosensitizing chemotherapeutic agents have been shown safe and effective for trimodal bladder cancer therapy***'''Various regimens of neoadjuvant, concurrent and adjuvant cisplatin-based regimens (e.g., cisplatin alone, CMV, cisplatin + paclitaxel or cisplatin + gemcitabine) have been studied.'''
+**Several radiosensitizing chemotherapeutic agents have been shown safe and effective for trimodal bladder cancer therapy
+***'''Various regimens of neoadjuvant, concurrent and adjuvant cisplatin-based regimens (e.g., cisplatin alone, CMV, cisplatin + paclitaxel or cisplatin + gemcitabine) have been studied.'''
 ***Alternatives for cisplatin-ineligible patients include gemcitabine or 5-fluorouracil and mitomycin C.
 ***Carboplatin should not be used as a radiosensitizer unless there are contraindications to cisplatin, 5-FU, and gemcitabine.
@@ Line 446: / Line 448: @@
 ****Cystoscopy per high-risk NMIBC schedule
 ****Cross-sectional imaging of the abdomen and pelvis and chest imaging every 6 months for the first 2 years
+**Unclear what proportion of patients who, having initially chosen bladder preservation, ultimately require cystectomy in a non-study setting.[https://pubmed.ncbi.nlm.nih.gov/38661067/]
 === Maximal TURBT/partial cystectomy ===