ABSTRACT

The standart of care for muscle-invasive transitional-cell carcinoma of the bladder is radical cystectomy (RC) with bilateral pelvic lymph node dissection, even though RC can be associated with significant morbidity. Organ conservation by combined-modality therapy which commonplace in contemporary oncology, with succes in cancer of breast, anus, larynx, l,imb, esophagus and prostate come into question for bladeer cancers as well. Modern bladder-sparing strategies combine maximal transuretheral resection of bladder tumor (TUR-B) followed by an induction course of concurrent radiation therapy and sensitizing chemotherapy. Aproximately ¾ of surviving patients maintain their bladder using combined-modality therapy with long term survival rates comparable to those of RS. Organ-sparing combined-modality therapies can be recommended for selected bladder cancer patients as a safe and proven alternative.