Bladder-Sparing Treatment of Invasive Bladder Cancer

BACKGROUND: Radical cystectomy with pelvic lymph node dissection is the standard treatment for patients with invasive bladder cancer. However, many alternative techniques to spare the bladder have been investigated. METHODS: We review the experience reported in the literature on bladder-sparing techniques, including transurethral resection, chemotherapy, and radiation for muscle-invasive disease. RESULTS: Most comparative studies indicate that local recurrence and survival outcomes for bladder-sparing approaches are inferior to those from radical cystectomy to control muscle-invasive bladder cancer. CONCLUSIONS: Although molecular biologic techniques may have the capacity to identify a subgroup who may benefit from a bladder-sparing approach, cystectomy is normally required for optimal results.