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    How do bladder Ca treatments compare in terms of survival?


    They found no significant differences in overall survival and disease-specific survival at 5 and 10 years. In both cases, results favored combined modality treatment at 5 years and radical cystectomy at 10 years. The difference in progression-free survival at 10 years was statistically insignificant, but favored combined modality treatment. There were no studies that examined progression-free survival at 5 years’ post-treatment.

    And while minor complication rates between the treatment options were similar, early major complications were more common among those treated with radical cystectomy.

    The traditional paradigm for treatment of muscle-invasive bladder cancer is built on basic assumptions that radical cystectomy is a superior approach and combined modality treatment should be reserved for patients who are not surgical candidates, including those with extensive comorbidities and/or poor performance status, according to Dr. Kaushik.

    Read: NMIBC guideline compliance remains low

    The take-home for urologists, he said, is not only the lack of difference in survival rates between radical cystectomy and combined modality treatment for these patients, but also that urologists should consider prompt salvage surgery for disease recurrence in the setting of failed radiation therapy.

    “Given the potential benefits of combined modality treatment, relative to radical cystectomy, clinical prediction of non-response to combined modality treatment would be of interest. These are the patients who can be selected early on for radical cystectomy. If predictive factors, such as pathology, genomic markers could be identified, patients might then be selected for the treatment most likely to benefit them. This may maximize overall cure rates and minimizing poor outcomes. Therefore, further clinical trials and translational research are required to identify optimal candidates for combined modality treatment,” Dr. Kaushik said.

    More from Urology Times:

    Chemotherapy may harness immune system in bladder Ca

    Software could help prevent post-cystectomy readmission

    Fluorescent cystoscopy outperforms white light method

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    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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