Myths About Bladder Preservation in Muscle-Invasive Bladder Cancer

摘要

Radical cystectomy is long considered as the "gold standard" in the management of local-ized muscle-invasive bladder cancer (MIBC), and curative intent radiotherapy is relegated to those with either inoperable tumors or with multiple co-morbidities precluding surgery. This is despite a large volume of data showing equal survival between the two modalities of treatment in this setting. In this work we seek to dispel some common myths surround-ing curative intent radiotherapy as part of a bladder preservation strategy in MIBC. Base -less claims of inferior outcomes and perceived contraindications for bladder preservation are debunked along with unfounded doubts relating to hypofractionation. Finally, we cau-tion against using response to neoadjuvant chemotherapy as a predictive biomarker for treatment selection and conclude by recommending that trimodality bladder preservation be offered as a therapeutic option that is in clinical equipoise with radical cystectomy. Semin Radiat Oncol 33:56-61 (c) 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/ 4.0/)