Bladder cancer
Initial treatment of MIBC

Diego (76 years old)

Diego is a 76-year-old retired chef who bakes special treats for his family during the weekend. He recently underwent cystoscopy for painless haematuria, which revealed a papillary tumour.

Assessment summary:

  • Diagnostic TURBT, pathological review:
    • pT2 UCa
    • Unifocal, no concomitant CIS
  • CT imaging: no upper tract disease and bladder mass suggestive for cT2b N0 M0
  • Ultrasound: no hydronephrosis
  • eGFR: 66 ml/min
  • No peripheral neuropathy
  • No hearing impairment
  • ECOG PS: 1
  • Cardiac ejection fraction: 70%

He received 4 cycles neoadjuvant gemcitabine + cisplatin. RC is planned for this patient.

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