Bladder-Sparing Approach Shows Promise for small-Cell bladder Cancer Patients
New research suggests patients with limited-stage small-cell bladder cancer (LS-SCBC) may achieve survival rates comparable to those undergoing radical surgery with a less invasive, bladder-preserving treatment strategy. A systematic review and meta-analysis published in clinical Genitourinary Cancer indicates that multimodal treatment utilizing transurethral resection of the bladder tumor (TURBT) with radiation-based multimodal chemotherapy (RBMMT) demonstrates non-inferiority to cystectomy-based multimodal therapy (CBMMT).
This finding offers a potential quality-of-life benefit for appropriate candidates, as it avoids the extensive recovery and potential complications associated with radical cystectomy – the complete removal of the bladder. LS-SCBC is a relatively rare and aggressive form of bladder cancer, impacting primarily older adults. The study analyzed data from five retrospective studies encompassing 1041 patients aged 66 to 76 years, with follow-up periods ranging from 15 to 70 months.
Researchers led by Dr. Tibor Szarvas of Semmelweis University, University of Duisburg-Essen, and the German Cancer Consortium, found median overall survival (OS) times of 34.6 months (95% CI, 25.5-43.7) with RBMMT and 29.7 months (95% CI, 18.2-41.1) with CBMMT. A sensitivity analysis at 60 months showed no significant difference in OS between the two approaches (0.83, 95% CI, 0.61-1.12; P =.22).”The demonstrated noninferiority of the less radical RBMMT approach supports its consideration as a bladder-preserving option, especially for patients placing a high value on [quality of life],” Dr. Szarvas’ team stated. While acknowledging the limitations of relying on retrospective data and variations in treatment protocols, the researchers advocate for larger, prospective studies to refine optimal treatment strategies and identify patient subgroups who may benefit most from either organ-sparing or more aggressive interventions.
Reference: Kubik A, das Virgens IPA, Varga N, et al. Radical surgery compared to bladder-preserving approaches for limited stage small-cell bladder cancer: systematic review and meta-analysis. Clin Genitourin Cancer. doi:10.1016/j.clgc.2025.102389
