Bladder cancer

Topic: Management of M0 muscle-invasive bladder cancer beyond radical cystectomy

Case 1: Paolo (62 years old)

Paolo, a 62-year-old teacher, was diagnosed with high-grade non-muscle-invasive bladder cancer (NMIBC) and underwent 6 cycles of Bacillus Calmette-Guérin (BCG) therapy. At follow-up cystoscopy, a tumour was found at the bladder neck.
 
Assessment summary:
  • Diagnostic transurethral resection of bladder tumour (TURBT): progression to muscle-invasive bladder cancer (MIBC), minimal pT2 UCa
  • Imaging: suggestive for cT3b N0M0 disease
  • Normal renal function
  • No peripheral neuropathy
  • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS): 0
  • Ejection fraction: 60%

What is the most appropriate treatment choice for this patient?