Clinical Scenario: T2 Bladder Tumor
The clinical scenario of a 48-year-old healthy man with 4 cm, T2 urothelial carcinoma and negative metastatic evaluation who desires immediate cystectomy without neoadjuvant chemotherapy, erectile function preservation, and an ileal neobladder is presented.
We recommend that cisplatinum-based neoadjuvant chemotherapy (NACT) be restricted to patients with undebated non-organ-confined urothelial BC (cT3, cT4a) and/or lymph node-positive disease (cNI). The chances of cure and of understaging are discussed with surgery, and capsule, prostate and seminal vesicle-sparing radical cystectomy (RC) is discussed as well as the high complication rates within 90 days of surgery (58 %) and long term (40 %). Postoperative care is outlined as well as differences in the robotic versus open approach and with a female patient.
KeywordsBladder cancer Radical cystectomy Nerve sparing Chemotherapy
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