Case 5: Keith (75 years old)

Keith is a retired, 75-year-old, engineer who still takes pride in solving problems with logic and precision. After a recent cystoscopy, Keith was told he has a papillary tumour. 

Assessment summary:

• Medical history: former smoker (50 pack years), hypertension
• ECOG PS: 1
• Maximal TURBT, resection visually complete
• Pathological review:
  • At least pT2
  • Pure urothelial carcinoma (UCa)
  • Unifocal, no concomitant CIS
  • Muscle in specimen
• Imaging: suggestive for cT3N1M0
• Ultrasound: no hydronephrosis
• eGFR: 70 ml/min
• No peripheral neuropathy
• No hearing impairment
• Cardiac ejection fraction: 62%