TY - JOUR
T1 - SIU–ICUD consultation on bladder cancer
T2 - treatment of muscle-invasive bladder cancer
AU - Leow, Jeffrey J.
AU - Bedke, Jens
AU - Chamie, Karim
AU - Collins, Justin W.
AU - Daneshmand, Siamak
AU - Grivas, Petros
AU - Heidenreich, Axel
AU - Messing, Edward M.
AU - Royce, Trevor J.
AU - Sankin, Alexander I.
AU - Schoenberg, Mark P.
AU - Shipley, William U.
AU - Villers, Arnauld
AU - Efstathiou, Jason A.
AU - Bellmunt, Joaquim
AU - Stenzl, Arnulf
N1 - Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2019/1/23
Y1 - 2019/1/23
N2 - Purpose: To provide a comprehensive overview and update of the Joint Société Internationale d’Urologie–International Consultation on Urological Diseases (SIU–ICUD) Consultation on Bladder Cancer for muscle-invasive presumably node-negative bladder cancer (MIBC). Methods: Contemporary literature was analyzed for the latest evidence in treatment options, outcomes, including radical surgery, neoadjuvant and adjuvant treatment modalities, and bladder-sparing approaches. An international multi-disciplinary expert panel evaluated and graded the data according to guidelines from the Oxford Centre for Evidence-Based Medicine. Results: Radical cystectomy (RC) is the standard of care for MIBC patients considered to be surgical candidates. While associated with substantial morbidity and mortality, this has been mitigated with improved technique, minimally invasive technology, and better perioperative care pathways (e.g., enhanced recovery after surgery). Neoadjuvant (NA) cisplatin-based combination chemotherapy improves overall survival and should be offered to eligible ≥ cT2N0 patients. Adjuvant (Adj) cisplatin-based combination chemotherapy may be considered, particularly for pT3–4 and/or pN+ disease without prior NA chemotherapy. Trimodal bladder-preserving treatment via maximum transurethral resection of bladder tumor followed by concurrent chemoradiation is safe and, when combined with early salvage RC for recurrence, offers long-term survival rates in selected patients comparable to RC. Immunotherapy is still experimental and is given either alone or in combination with chemotherapy and/or radiation. Conclusion: A multi-disciplinary approach is paramount to achieving optimal outcomes for MIBC patients, irrespective of their age, performance and nutritional status, fitness/frailty, renal and other organ function, or disease severity.
AB - Purpose: To provide a comprehensive overview and update of the Joint Société Internationale d’Urologie–International Consultation on Urological Diseases (SIU–ICUD) Consultation on Bladder Cancer for muscle-invasive presumably node-negative bladder cancer (MIBC). Methods: Contemporary literature was analyzed for the latest evidence in treatment options, outcomes, including radical surgery, neoadjuvant and adjuvant treatment modalities, and bladder-sparing approaches. An international multi-disciplinary expert panel evaluated and graded the data according to guidelines from the Oxford Centre for Evidence-Based Medicine. Results: Radical cystectomy (RC) is the standard of care for MIBC patients considered to be surgical candidates. While associated with substantial morbidity and mortality, this has been mitigated with improved technique, minimally invasive technology, and better perioperative care pathways (e.g., enhanced recovery after surgery). Neoadjuvant (NA) cisplatin-based combination chemotherapy improves overall survival and should be offered to eligible ≥ cT2N0 patients. Adjuvant (Adj) cisplatin-based combination chemotherapy may be considered, particularly for pT3–4 and/or pN+ disease without prior NA chemotherapy. Trimodal bladder-preserving treatment via maximum transurethral resection of bladder tumor followed by concurrent chemoradiation is safe and, when combined with early salvage RC for recurrence, offers long-term survival rates in selected patients comparable to RC. Immunotherapy is still experimental and is given either alone or in combination with chemotherapy and/or radiation. Conclusion: A multi-disciplinary approach is paramount to achieving optimal outcomes for MIBC patients, irrespective of their age, performance and nutritional status, fitness/frailty, renal and other organ function, or disease severity.
KW - Adjuvant chemotherapy
KW - Bladder-sparing
KW - Chemoradiation
KW - Enhanced recovery after surgery
KW - Muscle-invasive bladder cancer
KW - Neoadjuvant chemotherapy
KW - Radical cystectomy
KW - Transurethral resection of bladder tumor
KW - Trimodal
KW - Urothelial carcinoma of bladder
KW - Variant histology
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U2 - 10.1007/s00345-018-2606-y
DO - 10.1007/s00345-018-2606-y
M3 - Article
C2 - 30684034
AN - SCOPUS:85060763999
SN - 0724-4983
VL - 37
SP - 61
EP - 83
JO - World Journal of Urology
JF - World Journal of Urology
IS - 1
ER -