Bladder-Sparing Surgery for Invasive Bladder Cancer

A study has demonstrated that in patients with invasive bladder cancer, strategies aimed at sparing the bladder have just as good long-term cure rates as bladder removal. The study appeared in the July 2002 issue of Urology.

The standard of care for patients with invasive disease has been to completely remove the bladder and adjacent organs. Researchers at Massachusetts General Hospital (MGH, Boston, USA) used a tri-modality approach on 190 patients. First, surgery was performed to remove the patient's tumor from the bladder. Then, radiation and chemotherapy treatments were administered. Chemotherapy complements the cancer-killing effects of radiation, which are directed at the bladder itself. One-third of the patients did eventually require bladder removal, because tests showed that some cancer remained after the tri-modality approach was administered. Nonetheless, the 10-year survival rate for all patients in the study was as good as that of patients who had radical bladder removal.

The researchers note that current treatments are effective in reducing recurrence of cancer in the pelvic area, but 50% of all invasive bladder cancer patients eventually die from cancer that has spread. "That's why we include adjuvant chemotherapy, as is used for patients with breast cancer and other high-risk cancers, in an attempt to reach cancer cells throughout the body,” said Donald S. Kaufman, M.D., director of the MGH genitourinary cancer program.




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