Techniques for bladder preservation for muscle invasive bladder cancer

Richard Cowan

Christie NHS Foundation Trust, Manchester, UK

The debate continues regarding which of our patients should be offered a bladder preservation approach and which patients are better served by cystectomy. This question is being addressed in the UK by the NCRI SPARE trial.

We will highlight the characteristics at diagnosis which suggest that a radiotherapy based treatment will result in a favourable outcome particularly when preceeded by neo adjuvant chemotherapy. The addition of concurrent chemotherapy has been shown to improve the results of radiotherapy alone in a number of epithelial malignancies and we await results from large randomised trials within the UK to establish whether this will be the case with TCC of the bladder.

Exciting results have been obtained with the combination of Gemcitabine with radiotherapy in an NCRI phase II study and the updated results will be presented.