What does the EAU recommend for treatment of muscle-invasive bladder cancer?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

The EAU notes that radical cystectomy has traditionally been recommended for patients with muscle-invasive bladder cancer (MIBC), T2-T4a, N0-Nx, M0. [144] Other indications include the following:

  • High-risk and recurrent non–muscle-invasive tumors
  • T1G3 tumors that are unresponsive or refractory to BCG, or that relapse after BCG therapy
  • Extensive papillary disease that cannot be controlled with TURBT and intravesical therapy alone

Other EAU recommendations for muscle-invasive disease are as follows [144] :

  • Base the decision on bladder-sparing treatment or radical cystectomy in elderly/frail patients with invasive bladder cancer on tumor stage and comorbidity.
  • Assess comorbidity by a validated score, such as the Charlson Comorbidity Index. The American Society of Anesthesiologists score should not be used in this setting

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