Muscle-invasive transitional cell carcinoma of the bladder: strategies for bladder preservation.

: For patients with invasive bladder cancer, radical cystectomy remains the gold standard of treatment. However, based upon success with combination chemotherapy, physicians have begun to use this modality in an integrated approach with radiotherapy. This approach is of interest for elderly patients with poor medical conditions and for younger patients who may prefer to retain their bladders. Thorough transurethral resection of the bladder followed by chemotherapy with or without radiotherapy has become the focus of several studies. Bladder-conserving therapy may be offered to selected patients with invasive bladder cancer as a viable alternative to radical cystectomy.