Extra case 1: Luis (69 years old)

Luis, a 69-year-old retired history teacher, enjoys spending his mornings walking along the river near his home. He was diagnosed with high-grade NMIBC without CIS and underwent induction with BCG (6/6). At follow-up cystoscopy six weeks after the last BCG cycle, a tumour was found at the bladder neck.

Assessment summary:

• No relevant medical history
• Maximal TURBT, visually complete
• Pathological review:
  • At least pT2 urothelial carcinoma
  • Unifocal, no concomitant CIS
• Transurethral biopsy of the prostatic urethra, pathological review:
  • No prostatic urethral involvement
• Imaging: suggestive for cT2N0M0
• Ultrasound: no hydronephrosis
• eGFR: 66 ml/min
• No peripheral neuropathy
• No hearing impairment
• ECOG PS: 0
• Cardiac ejection fraction: 60%

Concurrent RT + radiosensitising cisplatin is planned according to discussion at the multidisciplinary tumour board.