Partial Cystectomy for Invasive Bladder Cancer

Abstract

Background. Radical cystectomy with pelvic lymph node dissection is the standard treatment for patients with invasive bladder cancer. However, many alternative techniques to spare the bladder have been investigated. Single-center, non-randomized studies have reported good patient’s acceptance and reasonably good treatment outcomes.

Methods. We review the experience reported in the literature on bladder-sparing techniques, including transurethral resection, chemotherapy, radiation, and multimodality approaches for muscle-invasive disease focussing on controlled clinical trials.

Results. Most comparative studies indicate that local recurrence and survival outcomes for bladder-sparing approaches are inferior to those from radical cystectomy to control muscle-invasive bladder cancer.

Conclusions. Although molecular biologic techniques may have the capacity to identify a subgroup of patients who may benefit from a bladder-sparing approach, cystectomy is normally required for optimal results. Nevertheless, several alternatives to radical cystectomy for muscle-invasive bladder cancer have been studied. None, however, are reliably superior to radical operative treatment.