Single modality bladder sparing therapy for muscle-invasive @entity150 , including transurethral resection, systemic chemotherapy or radiotherapy have been demonstrated to result in insufficient local control of the @entity5 as well as decreased long-term survival of the @entity1 when compared to radical cystectomy. Therefore, multimodality treatment protocols that aim at bladder preservation and involve all of the aforementioned approaches have been established. Arguments for combining systemic chemotherapy with radiation are to sensitize @entity5 tissue to radiotherapy and to eradicate occult metastases that have already developed in as many as 50% of @entity1 at the time of first diagnosis. It has been shown that the clinical outcome observed with this approach approximates that after radical cystectomy. Additionally, a substantial number of @entity1 survive with an intact bladder. However, bladder preserving approaches are costly, and require close co-operation between different clinical specialists as well as very close follow-up. The good long-term results obtained after cystectomy and creation of an orthotopic neobladder make the possible advantage of a bladder preservation strategy questionable in consideration of quality of life issues. Additionally, side effects related to bladder sparing therapy may result in an increased morbidity and mortality in those @entity1 who in fact need to undergo surgery due to recurrent or progressive disease. Multimodality bladder sparing treatment is a therapeutic option that can be offered to the @entity1 at centres that have a dedicated multidisciplinary team at their disposal. However, radical cystectomy remains the standard of care for muscle-invasive @entity150 .

Is there a role for bladder preserving strategies in the treatment of muscle-invasive XXXX ?

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'primary tumor'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity150 :: ('MESH:D001749', 'Disease') :: ['bladder tumors', 'bladder cancer']
@entity150 :: (MESH:D001749,Disease) :: ['bladder cancer']
