Radical cystectomy with lymph node dissection and urinary diversion is the gold-standard treatment for non-metastatic muscle-invasive bladder cancer (MIBC). However, in patients who refuse cystectomy, or in whom cystectomy carries a high risk, bladder-preserving therapies remain potential options. Bladder preservation therapies can include maximal debulking transurethral resection of bladder tumor (TURBT), concurrent chemoradiation therapy, followed by cystoscopy to assess response. At this time, maximal TURBT is recommended for patients prior to the initiation of chemoradiation therapy or in patients with residual bladder tumors after the completion of chemoradiation therapy. That being said, TURBT carries significant risks such as bladder perforation, bleeding, and infection, ultimately risking delayed systemic treatment. Hence, understanding its role within trimodal therapy is crucial to avoid undue suffering in patients. Herein, we review the current literature on the impact of debulking TURBT in non-metastatic MIBC.
Cancers. 2024 Sep 30*** epublish ***
Farshad Sheybaee Moghaddam, Sami Dwabe, Nataliya Mar, Leila Safdari, Navin Sabharwal, Hanan Goldberg, Michael Daneshvar, Arash Rezazadeh Kalebasty
Institute of Urology, University of Southern California, Los Angeles, CA 90089, USA., Department of Medicine, University of California Irvine, Orange, CA 92868, USA., Department of Medicine, University of Southern California, Los Angeles, CA 90089, USA., Department of Urology, University of Irvine, Orange, CA 92868, USA., Department of Urology, SUNY Upstate Medical University, Syracuse, NY 13210, USA.