Bladder cancer
NEW --- Initial treatment of MIBC

Case 2: Octavia (69 years old)

Octavia, a 69-year-old ceramics enthusiast, spends her days shaping clay in her spacious home, producing functional pieces for her family. She recently underwent cystoscopy for painless haematuria, revealing a papillary bladder tumour. Her past medical history includes stable coronary artery disease, hypertension and borderline diabetes. She quit smoking 25 years ago.

Assessment summary:

  • Diagnostic TURBT, pathological review:
    • At least pT2 UCa
    • Unifocal, no concomitant CIS
  • Imaging: suggestive for cT3N0M0
  • Ultrasound: no hydronephrosis
  • eGFR: 35 ml/min
  • No peripheral neuropathy
  • No hearing impairment
  • ECOG PS: 0
  • Cardiac ejection fraction: 55%

Multidisciplinary tumour board assessed that patient is a candidate for RC + PLND.

Which of the following treatment options would you choose for this patient?