Hassan Khaled Hamdy*
Department of Clinical Oncology, Al-Hussein University Hospital, EgyptFulltext PDF
In many centers, radical cystectomy is the standard treatment of non-metastatic muscle invasive bladder cancer. In most series, 5-year pelvic control rates of 80% to 90% and 5-year overall and disease-specific survival rates of 59% to 60% and 55% to 65% respectively, are achieved. The major drawback is the associated incontinence and impotence, occurring in 15% –50% and 40%–60% of cases, respectively. Trimodal therapy with cystoscopy resection and chemo-radiation has an evolving role, with privilege of bladder preservation. Recently, a comparable outcome to radical cystectomy can be achieved with this modality; thanks to the evident survival benefit of adding neoadjuvant chemotherapy and the advances in radiation therapy techniques. Image guided and intensity modulated radiation therapy offer the opportunity to enhance the therapeutic ratio by reducing the irradiated volume of organs at riskand escalating the dose to the planned clinical target volume. Also, it facilitates salvage cystectomy with accepted levels of morbidity and mortality.In conclusion, trimodal therapy is a valid treatment option that can be discussed with all patients with non-metastatic muscle invasive bladder cancer.
Muscle invasive bladder;Radical cystectomy;Neo adjuvant chemotherapy;Trimodal therapy; Bladder preservation
Hamdy HK. A Dream Comes True: Trimodal Therapy is a Valid Option for Patients with Muscle Invasive Bladder Cancer. J Surg Tech Proced. 2017; 1(1): 1004.