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Bladder Preservation Therapy: Review of Literature and Future Directions of Trimodal Therapy

  • Urothelial Cancer (S Daneshmand, Section Editor)
  • Published:
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Abstract

Purpose of the Review

This review targets the latest literature on bladder preservation therapy with emphasis on trimodal therapy (TMT), highlighting its role in the management of muscle invasive bladder cancer (MIBC) and outlining future directions in bladder preservation research.

Recent Findings

TMT is the most promising bladder preservation treatment modality. Comparable results to contemporary radical cystectomy series are seen in properly selected patients. A multidisciplinary team approach is critical in the management of these patients. Future research is directed at the integration of immunotherapy into the treatment protocol.

Summary

TMT, involving maximal transurethral resection followed by chemoradiation, is an attractive alternative to radical cystectomy with urinary diversion in carefully selected patients with muscle invasive disease. In the absence of randomized trial (RCT), comparison between TMT and cystectomy, based on retrospective data from large centers, suggests comparable oncological outcomes, with a favorable impact on quality of life.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Experimental surgery, McGill University Health Center, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada

    Adnan El-Achkar

  2. Department of Radiation Oncology, McGill University Health Center, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada

    Luis Souhami

  3. Department of Surgery, McGill University Health Center, McGill University, 1001 Decarie Blvd, D02.7210, Montreal, QC, H4A 3J1, Canada

    Wassim Kassouf

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  1. Adnan El-Achkar
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Adnan El-Achkar, Luis Souhami, and Wassim Kassouf each declare no potential conflicts of interest.

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El-Achkar, A., Souhami, L. & Kassouf, W. Bladder Preservation Therapy: Review of Literature and Future Directions of Trimodal Therapy. Curr Urol Rep 19, 108 (2018). https://doi.org/10.1007/s11934-018-0859-z

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