Bladder preservation in muscle-invasive bladder cancer by conservative surgery and radiochemotherapy

Juergen Dunst*, Claus Rödel, Anthony Zietman, Karl M. Schrott, Rolf Sauer, William U. Shipley

*Corresponding author for this work
41 Citations (Scopus)


Organ preservation has been investigated in muscle-invasive bladder cancer over the past decades as an alternative to standard radical cystectomy. The results of large prospective protocols and population-based studies suggest that an organ-preserving approach is possible without deferring the survival probability. Organ preservation requires a trimodal schedule, including transurethral surgery (transurethral resection of bladder tumor (TURBT)), radiation, and chemotherapy. A complete TURBT is the most important single prognostic factor, and should be attempted. Radiotherapy, in conjunction with concurrent platinum-based chemotherapy, can control the vast majority of urothelial bladder tumors. The histologically-proven complete remission rates of macroscopic tumors (unresectable by TURBT) lie in the range of about 70%. After radiochemotherapy, a histological response evaluation with repeated TURBT is recommended. Patients with residual tumor require salvage cystectomy. In cases of complete remission, patients can maintain their bladders but they should be closely followed over years. The risk of severe late-radiation sequelae is low, in the range of less than 5%. About 75% of long-term survivors maintain a normally functioning bladder.

Original languageEnglish
JournalSeminars in Surgical Oncology
Issue number1
Pages (from-to)24-32
Number of pages9
Publication statusPublished - 2001


Dive into the research topics of 'Bladder preservation in muscle-invasive bladder cancer by conservative surgery and radiochemotherapy'. Together they form a unique fingerprint.

Cite this