Survival comparable with bladder-sparing trimodal therapy and radical cystectomy
medwireNews: A propensity score-matched cohort analysis finds no significant difference between bladder-sparing trimodal therapy (TMT) and radical cystectomy with respect to survival in patients with muscle-invasive bladder cancer (MIBC).
Although radical cystectomy is considered the standard of care for these patients, bladder-preservation approaches – such as TMT, which comprises transurethral resection of bladder tumour, chemotherapy for radiation sensitization, and external beam radiotherapy – have emerged in recent years, the Canadian research team explains in the Journal of Clinical Oncology.
In the absence of randomized trials comparing the approaches, the study authors identified 56 patients who underwent TMT at their institution and matched them by demographic and clinical parameters to an equal number who underwent radical cystectomy.
During a median follow-up of 4.51 years, the overall mortality rate was 39.3% in the TMT group and a comparable 35.7% in the radical cystectomy group, while the corresponding 5-year disease-specific survival rates were 76.6% and 73.2%.
Alexandre Zlotta, from Mount Sinai Hospital in Toronto, Ontario, and co-authors therefore suggest that “[a]ppropriately selected patients with MIBC should be offered the opportunity to discuss various treatment options, including organ-sparing TMT.”
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