ABSTRACT
Introduction The treatment options for muscle-invasive bladder cancer can be broadly divided into organ-sparing regimens and those that require immediate removal of the bladder. Radical cystectomy with surgical removal of the bladder, its adnexae, and the regional lymph nodes represents the most prevalent treatment offered in the US. Radiation
recommended for patients deemed ‘unfit’ for surgery secondary to advanced age, comorbidities or disease extent. Consequently, when comparisons of retrospective radiation and surgical series have been made, better outcomes for patients undergoing cystectomy are reported. This comparison is further confounded as an additional 15% of patients are excluded from cystectomy series secondary to intraoperative discovery of extravesical tumor extension, prompting abortion of the procedure. In contrast to historic series, modern bladder-sparing regimens do not consist of radiation monotherapy but are typified by a multimodality approach.
