Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review

Abstract

PurposeRadical cystectomy currently is the treatment of choice in muscle-invasive bladder cancer. However, cystectomy is associated with considerable morbidity. Bladder sparing treatment consists of transurethral resection of the tumor (with or without partial cystectomy), external beam radiotherapy, and brachytherapy. The purpose of this study is to compare bladder preservation with brachytherapy to cystectomy by a systematic review.Material and methodsA systematic review was conducted using PubMed electronic database. Article selection was done independently by two authors. Data were extracted on cause-specific survival and overall survival at 2, 5, and 10 years. Comparison of the two treatment modalities was done by a Weibull survival analysis with metaregression analysis and estimation of Hazard Ratio's (HR's) with 95% confidence intervals (CI).ResultsLarge differences in tumor staging and tumor grading were found between cystectomy and bladder sparing series. The adjusted HR's for cause-specific survival and overall survival were 1.27 (95% CI: 1.15-1.40) and 0.85 (95% CI: 0.84-0.87), respectively for bladder sparing relative to radical cystectomy.ConclusionsRobustness of the analysis is hampered by the retrospective character of the study and differences in patient characteristics. For selected cases, bladder sparing by brachytherapy leads to at least similar overall survival compared to radical cystectomy for muscle invasive bladder cancer.

Bladder cancer stage-associated hub genes revealed by WGCNA co-expression network analysis

“…Transurethral resection (TUR) with fulguration was suitable for treating superficial bladder cancer while radical cystectomy was often rendered for patients with bladder cancer at the advanced stage in the situation of which the organs near the bladder such as the prostate and the seminal vesicles of a male patient and the uterus, the ovaries, and part of the vagina of a female need to be removed [4]. Partial cystectomy can be offered to patients who have a low-grade tumor that has invaded the bladder wall but was limited to one area of the bladder [5–7]. Biological therapy was an emerging revolution in the medical field, which involved the use of living organisms, substances derived from living organisms, or laboratory-produced versions of such substances to treat diseases.…”

Robot-assisted laparoscopic implantation of brachytherapy catheters in bladder cancer recent interests and prospective

“…Patients with low-volume T2 disease without hydronephrosis, extensive carcinoma in situ and tumors not located in the bladder neck or the prostatic urethra in male patients are the candidates of bladder preservation. Recent evidences are consistent about equivocal outcome of trimodal Bladder conservation therapy when compared with RC in properly selected cases ( 5 - 8 ).…”

Robot-assisted brachytherapy of the bladder with long distance support using video conferencing

“…Brachytherapy centers in the Netherlands advocate for TMT, integrating a moderate dose of pelvic EBRT with a brachytherapy boost using a minimally invasive procedure in the context of organ preserving treatment for selected MIBC patients. They have demonstrated a local control and survival similar to CMT with approximately 90% of the patients cured and retaining an effectively functioning bladder [ 6 , 8 , 9 , 23 , 26 , 27 , 28 , 29 ]. Thus, the preservation of a functioning bladder remains one of the most important advantages for selected patients of all age groups.…”