Bladder cancer
Initial treatment of MIBC

Maverick (75 years old)

Maverick is a 75-year-old philosopher who believes that the end of humanity will happen on 21 December 2112 through an alien invasion.

He underwent cystoscopy for painless haematuria, which revealed a papillary tumour.

Assessment summary:

  • Pathological review maximal TURBT:
    • Minimal pT2 UCa
    • Unifocal, no concomitant CIS
  • Imaging: suggestive for cT2 cN2 cM0
  • Ultrasound: no hydronephrosis
  • eGFR: 70 ml/min
  • No peripheral neuropathy
  • No hearing impairment
  • ECOG PS: 1

The patient completed 4 cycles of induction gemcitabine + cisplatin with complete response (CR).

  • Imaging: suggestive for cT0 cN0 cM0
  • Cystoscopy: no tumour

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