Choice of the optimal treatment strategy for patient with multifocal bladder cancer: clinical case

Transurethral resection of bladder is the standard surgical procedure for management of bladder cancer when it is suspected. Accurate clinical staging of the disease based on the histologic findings followed by further assessment of recurrence risks and risks of disease progression are vital for defining an optimal individualized treatment strategy. Early radical cystectomy (RC) is recommended for patients suffering from superficial bladder cancer at high risk for tumor recurrence.

Patients diagnosed with bladder tumors with multifocal lesions as well as with tumor size > 3 сm are related to a group of high risk for cancer progression. In this case in order to take a decision about the benefits of radical surgery, it’s essential to remember that RC is considered to be a major surgical procedure with a broad range of both intraoperative and postoperative complications. The vast majority of patients experience a lower quality of life based on the development of different types of metabolic alterations as well as the necessity for using urinals or inability to have adequate urination control. Organ-preserving therapy with active follow-up is thereby preferably to conduct on young patients with active life position.

In our clinical case we confirmed that such treatment strategy allows to establish adequate control over neoplastic process with less negative impact on patients’ quality of life.