Treatment of Muscle-Invasive Bladder Cancer with Solitary cT2–T3a Tumor and Preserved Bladder Function
Clinical Scenario
This protocol addresses muscle-invasive bladder cancer in patients with a specific disease profile that supports curative bladder-preserving treatment:
- Solitary, unifocal cT2–T3a tumor
- Absence of extensive or multifocal carcinoma in situ
- No or unilateral hydronephrosis
- Good baseline bladder function
Treatment Approach
Trimodality therapy is a primary curative option in this setting, combining a maximal surgical step with concurrent chemoradiation to the bladder.
Full regimen selection, sequencing, and dosing details are in the structured protocol below.
Treatment Goal
Achieve durable local control while preserving bladder function and quality of life.
Complete response with intact bladder
References
- Trimodality therapy is best suited for patients with solitary, unifocal cT2–T3a tumours, absence of extensive or multifocal CIS, no or unilateral hydronephrosis, and good baseline bladder function.
- Trimodality therapy should also be considered for patients medically unfit or unwilling to undergo RC.
- Offer radical cystectomy or bladder-preserving trimodality treatment (TMT) as primary curative option for eligible patients since they are more effective than radiotherapy alone.
- Combined chemotherapy and RT is more effective than RT alone in bladder sparing treatment.
- Trimodality therapy aims to achieve durable local control without compromising oncological outcome while also preserving bladder function and QoL.
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