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Bladder Tumors: pp 311–330Cite as

Radical Surgery for Muscle-Invasive Bladder Cancer

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Part of the book series: Cancer Drug Discovery and Development ((CDD&D))

Abstract

Background: Radical cystectomy offers the best opportunity for ultimate cure of high-grade and high-risk invasive bladder cancer.

Objective: To review the available literature on the indication and oncological outcome of radical cystectomy for urothelial carcinoma of the bladder. A database search of the U.S. National Library of Medicine (PubMed) was performed for relevant medical articles using the Medical Subject Headings “invasive bladder cancer” and “radical cystectomy” with restrictions to English language publications.

Evidence: Immediate or early radical cystectomy offers excellent recurrence-free and disease-specific survival rates as well as local tumor control in patients with organ-confined and node-negative disease. Tumor control in nonorgan-confined tumors is satisfactory with long-term recurrence-free survival rates of about 50%. For node-positive disease, surgery may still be curative in approximately one-fourth of patients.

Conclusions: Evidence from the literature supports an early aggressive surgical management for invasive bladder cancer. Risk-stratification of patients with bladder cancer based on pathologic features at initial TUR or at recurrence can select those most appropriate for radical cystectomy early. In patients with organ-confined, lymph node-negative urothelial bladder carcinoma excellent long-term survival rates can be achieved.

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Authors and Affiliations

  1. Department of Urology, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany

    Juergen E. Gschwend

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  1. Juergen E. Gschwend
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Correspondence to Juergen E. Gschwend .

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Editors and Affiliations

  1. Miller School of Medicine, Dept. Urology & Cell Biology & Anatomy, University of Miami, NW. 10th Avenue 1400, Miami, 33136, Florida, USA

    Vinata B. Lokeshwar

  2. , Department of Urology and Urologic Oncol, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Axel S. Merseburger

  3. Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Str. 7, Kiel, 24105, Germany

    Stefan H. Hautmann

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Gschwend, J.E. (2011). Radical Surgery for Muscle-Invasive Bladder Cancer. In: Lokeshwar, V., Merseburger, A., Hautmann, S. (eds) Bladder Tumors:. Cancer Drug Discovery and Development. Humana Press. https://doi.org/10.1007/978-1-60761-928-4_16

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  • DOI: https://doi.org/10.1007/978-1-60761-928-4_16

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