comparison between a bladder sparing approach and a radical cystectomy in patients with a non-metastasized muscle invasive bladder carcinoma

A bladder sparing treatment with radiochemotherapy or brachytherapy in patients with non-metastasised muscle invasive bladder carcinoma leads to comparable disease free survival and overall survival rates compared to radical cystectomy in non-randomised comparative retrospective studies. In over 70% of patients the bladder and its function can be preserved with bladder sparing treatments. However, a radical cystectomy is still considered as standard treatment by the lack of randomized controlled trials. It is very unlikely that such a trial will be conducted. Prospective matched control studies are second best in the comparison of outcome between both treatment. It is likely that medical costs, toxicity and quality of life will be better in the sparing approach arm, but again not previously prospectively analyzed.

A bladder sparing approach results in comparable disease free survival, overall survival with less toxicity, less costs and a high functional bladder preservation rate compared to a radical cystectomy.

DFS at 2 and 5 years

NA