Bladder cancer
Initial treatment of MIBC

Arturo (78 years old)

Arturo is a 78-year-old electronic engineer, who still enjoys designing telecommunication systems in his private lab. He recently underwent cystoscopy for painless haematuria, which revealed a papillary tumour.

Assessment summary:

  • No relevant medical history
  • Maximal TURBT, visually complete
  • Pathological review:
    • pT2 UCa
    • Unifocal, no concomitant CIS
  • Imaging: suggestive for cT2 cN0 cM0
  • Ultrasound: no hydronephrosis
  • eGFR: 50 ml/min
  • No peripheral neuropathy
  • No hearing impairment
  • ECOG PS: 1
  • Cardiac ejection fraction: 65%
  • No voiding symptoms

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