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Urología Colombiana
On-line version ISSN 2027-0119
Abstract
ABONFA-VELASCO, Carlos H. and GARCIA-PERDOMO, Herney A.. Management of muscle-invasive bladder cancer with an organ-sparing approach: trimodal therapy. Urol. Colomb. [online]. 2023, vol.32, n.1, pp.9-14. Epub May 18, 2024. ISSN 2027-0119. https://doi.org/10.24875/ruc.23000007.
Introduction:
Bladder cancer is a frequent pathology of the genitourinary tract, whose treatment causes morbidity and impaired quality of life, particularly in the subgroup of patients with bladder tumors classified as muscle invaders. In recent years, therapeutic alternatives have been sought for radical cystectomy + extended pelvic lymphadenectomy, which is currently the standard of care for patients with muscle-invasive bladder carcinoma. With the advent of less ablative oncologica! management profiles but without sacrificing oncological results and with new radiotherapy and chemotherapy techniques, organ-sparing therapeutic modalities such as trimodal therapy (transurethral resection of bladder tumor + chemotherapy + radiotherapy) becomes a viable therapeutic alternative with satisfactory long-term oncological results.
Objective and methodology:
This review aims to show the current status of trimodal therapy in the management of muscle-invasive bladder tumors, define the best patients to consider for receiving this therapy, present the oncological results compared with the management standard and the results in quality of life. A management algorithm is also proposed and recommendations in this regard are presented in clinical practice guidelines,
Conclusions:
Trimodal therapy is an alternative to standard management that leads to acceptable oncological outcomes and can be considered a treatment option in well-selected patients.
Keywords : Trimodal therapy; Muscle-invasive bladder câncer; Radical cystectomy; Transurethral resection; Radiotherapy; Chemotherapy.