title: Elective bladder-sparing treatment for muscle invasive bladder cancer.
abstract: OBJECTIVE
  Radical cystectomy is the standard treatment for localised muscle invasive bladder cancer (MIBC). We offer a bladder-sparing treatment with TURB +/- Chemotherapy+Radiotherapy to selected patients as an alternative.
  
  
  METHODS
  We analyze, retrospectively, 30 patients diagnosed with MIBC from March 1991 to October 2010. The mean age was 62.7 years (51-74). All patients were candidates for a curative treatment, and underwent strict selection criteria: T2 stage, primary tumor, solitary lesion smaller than 5cm with a macroscopic disease-free status after TURB, negative random biopsy without hydronephrosis. Staging CT evaluation was normal. Restaging TURB or tumor bed biopsy showed a disease-free status or microscopic muscle invasion. 14 patients underwent TURB alone, 13 TURB+Chemotherapy and 3 TURB+Chemotherapy+Radiotherapy.
  
  
  RESULTS
  The mean follow up was 88.7 months (19-220). 14 patients remained disease free (46.6%), 10 had recurrent non-muscle invasive bladder cancer (33%). 81.3% complete clinical response. 71% bladder preserved at 5-years. Overall, 5-years survival rate was 79% and 85% cancer-specific survival rate.
  
  
  CONCLUSIONS
  Although radical cystectomy is the standard treatment for localised MIBC, in strictly selected cases, bladder-sparing treatment offers an alternative with good long term results.
authors.affiliation: Servicio de Urología, Hospital Universitario Nuestra Señora de Valme, Sevilla, España. Electronic address: glendinez@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Lendínez-Cano
authors.affiliation: Servicio de Urología, Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
authors.forename: J
authors.initials: J
authors.lastname: Rico-López
authors.affiliation: Servicio de Urología, Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
authors.forename: S
authors.initials: S
authors.lastname: Moreno
authors.affiliation: Servicio de Oncología, Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
authors.forename: E
authors.initials: E
authors.lastname: Fernández Parra
authors.affiliation: Unidad de Estadística, Metodología y Evaluación de la investigación, Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
authors.forename: C
authors.initials: C
authors.lastname: González-Almeida
authors.affiliation: Servicio de Urología, Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
authors.forename: E
authors.initials: E
authors.lastname: Camacho Martínez
mesh_terms: D000368:Aged; D000465:Algorithms; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D059351:Organ Sparing Treatments; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy
keywords: Bladder cancer; Bladder-sparing; Chemotherapy; Conservación vesical; Cáncer vesical; Quimioterapia; Radioterapia; Radiotherapy; Resección transuretral; Transurethral resection