This protocol applies to patients with muscle-invasive pure squamous cell carcinoma (SCC) of the bladder or muscle-invasive pure adenocarcinoma of the bladder — histological subtypes that carry distinct management considerations separate from the more common urothelial carcinoma.
Pure SCC and pure adenocarcinoma are non-urothelial histologies. When they reach muscle-invasive depth, clinical evidence indicates their behaviour — and the expected benefit from certain treatment modalities — differs meaningfully from that of standard urothelial carcinoma. Patients with these subtypes may have worse survival outcomes with bladder-preserving multimodal therapy and require specific counselling regarding the preferred treatment pathway.
The recommended management for these specific histological subtypes involves a primary surgical intervention as the preferred upfront approach. The complete protocol — including the precise procedure, its extent, and the full evidence-based rationale — is available in the structured regimen below.