title: Bladder preservation in non-metastatic muscle-invasive bladder cancer (MIBC): a single-institution experience.
abstract: The aim of this study is to access the feasibility, toxicity profile, and tumour outcome of an organ preservation curative approach in non-metastatic muscle-invasive bladder cancer. A retrospective analysis was conducted on patients affected by M0 bladder cancer, who refused cystectomy and were treated with a curative approach. The standard bladder preservation scheme included maximal transurethral resection of bladder tumour (TURBT) and combination of radiotherapy and platin-based chemotherapy, followed by endoscopic evaluation, urine cytology, and instrumental evaluation. Thirteen patients fulfilled the inclusion criteria. TNM stage was cT2cN0M0 and cT2cNxM0, in 12 and one patients, respectively. All patients had transitional cell cancer. Twelve patients completed the whole therapeutic programme (a bimodal treatment without chemotherapy for one patient). Median follow-up is 36 months. None of the patients developed severe urinary or intestinal acute toxicity. In 10 patients with a follow-up > 6 months, no cases of severe late toxicity were observed. Response evaluated in 12 patients included complete response and stable disease in 11 patients (92%), and one patient (8%), respectively. At the time of data analysis (March 2016), 10 patients (77%) are alive with no evidence of disease, two patients (15%) died for other reasons, and one patient has suspicious persistent local disease. The trimodality approach, including maximal TURBT, radiotherapy, and chemotherapy for muscle-invasive bladder cancer, is well-tolerated and might be considered a valid and feasible option in fit patients who refuse radical cystectomy.
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Marianna A
authors: MA
authors: Gerardi
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Barbara A
authors: BA
authors: Jereczek-Fossa
authors: Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Dario
authors: D
authors: Zerini
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Alessia
authors: A
authors: Surgo
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Samantha
authors: S
authors: Dicuonzo
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Ruggero
authors: R
authors: Spoto
authors: Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Cristiana
authors: C
authors: Fodor
authors: Medical Division of Urogenital Tumours, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Elena
authors: E
authors: Verri
authors: Medical Division of Urogenital Tumours, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Maria Cossu
authors: MC
authors: Rocca
authors: Medical Division of Urogenital Tumours, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Franco
authors: F
authors: Nolè
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Matteo
authors: M
authors: Muto
authors: Division of Urologic Cancer Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Matteo
authors: M
authors: Ferro
authors: Division of Urologic Cancer Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Gennaro
authors: G
authors: Musi
authors: Division of Urologic Cancer Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Danilo
authors: D
authors: Bottero
authors: Division of Urologic Cancer Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Deliu V
authors: DV
authors: Matei
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Urologic Cancer Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Ottavio
authors: O
authors: De Cobelli
authors: Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy; Division of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy.
authors: Roberto
authors: R
authors: Orecchia
keywords: concomitant chemoradiotherapy; organ preservation; trimodality; urinary bladder cancer