[Alternatives to cystectomy].

BACKGROUND

In many cases radical cystectomy is not feasible in patients suffering from muscle-invasive bladder cancer due to advanced age of the patient or limiting comorbidities which increase the perioperative risk. A further group of patients decline radical cystectomy due to potential postoperative complications and the resulting impairment in the quality of life.

OBJECTIVES

This article provides an overview of alternative therapeutic concepts to radical cystectomy in muscle-invasive bladder cancer.

MATERIAL AND METHODS

The study involved a database analysis and gives a discussion of clinical trials concerning alternative therapeutic concepts for muscle-invasive bladder cancer treatment strategies.

RESULTS

Transurethral resection, open partial cystectomy, radiotherapy, chemotherapy and combined therapeutic regimens are available as alternatives to radical cystectomy.

CONCLUSION

Radical cystectomy is the accepted standard of care in the treatment of muscle-invasive bladder cancer but in selected patients, established alternative methods can also be offered. A comprehensive patient information and counseling is therefore necessary to find the best therapeutic option in each individual case. Salvage cystectomy is a therapeutic option in cases of failure of organ-preserving treatment.