Combination therapy and function-sparing surgery for muscle-invasive bladder cancer

The American Cancer Society has estimated that there will be 53,200 new cases of bladder cancer diagnosed in the United States this year.1 Of these, approximately 70% will be of the superficial subtype that can frequently be managed with transurethral resection (TUR), intravesical therapy in selected cases, and careful surveillance for recurrence or progression. The remaining 30% of patients, however, are diagnosed with a far more virulent phenotype of bladder cancer that is invasive into the muscular wall of the bladder, demonstrates significantly increased metastatic potential, and is responsible in large part for the considerable morbidity and mortality associated with the disease. Over 12,200 people are estimated to die from bladder cancer this year, and the overwhelming majority of these patients represent those who present with an invasive phenotype that progresses to metastatic disease.1