Bladder cancer
Initial treatment of MIBC

Daniela (69 years old)

Daniela, 69 years old, worked her whole life in a dog shelter. Now that she is retired, she misses the dogs enormously. That’s why she decided to adopt 5 dogs from the shelter.

She recently underwent cystoscopy for painless haematuria, which revealed a papillary tumour. Her past medical history includes stable coronary artery disease, hypertension and borderline diabetes mellitus. She quit smoking 25 years ago.

Assessment summary:

  • Diagnostic transurethral resection of bladder tumour (TURBT), pathological review:
    • Minimal pT2 UCa
    • Unifocal, no concomitant carcinoma in situ (CIS)
  • Imaging: suggestive for cT3b cN0 cM0
  • Ultrasound: no hydronephrosis
  • eGFR: 66 ml/min
  • No peripheral neuropathy
  • No hearing impairment
  • ECOG PS: 1
  • Cardiac ejection fraction: 70%

 RC + pelvic lymph node dissection (PLND) is planned.

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