title: [Bladder preservation possibilities in the treatment of muscle-invasive bladder cancer].
abstract: Radical cystectomy is the standard of treatment for muscle-invasive transitional cell carcinoma of the bladder in European Union and in United States. During the last few decades, several clinical trials were performed with the aim to evaluate new treatment methods as an alternative to radical cystectomy for selected patient groups. According to some clinical trials, it is clear that bladder preservation is possible without compromising overall survival of these patients. Organ preservation requires a combined-modality treatment including transurethral resection of bladder tumor, radiation therapy, and systemic chemotherapy. Incorporation of chemotherapeutic agents such as gemcitabine or taxanes in bladder-sparing protocols improves the results of conservative treatment of locally advanced bladder cancer. Pretreatment selection criteria and the most important prognostic factors are macroscopically complete transurethral resection of bladder tumor, absence of hydronephrosis, and lower T stage.
authors.affiliation: Institute of Oncology, Vilnius University, Vilnius, Lithuania.
authors.forename: Jolita
authors.initials: J
authors.lastname: Asadauskiene
authors.forename: Eduardas
authors.initials: E
authors.lastname: Aleknavicius
authors.forename: Terese Pipiriene
authors.initials: TP
authors.lastname: Zelviene
authors.forename: Feliksas
authors.initials: F
authors.lastname: Jankevicius
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy; D015653:Cystectomy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D014747:Vinblastine / Q000627:therapeutic use; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D043823:Taxoids; D003841:Deoxycytidine; D014747:Vinblastine; D004317:Doxorubicin; D016190:Carboplatin; D002945:Cisplatin; D008727:Methotrexate; D000093542:Gemcitabine