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Invited Commentary
October 2018

Bladder Extirpation vs Preservation: The Treatment Debate

Author Affiliations
  • 1Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
  • 2Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
JAMA Surg. 2018;153(10):889-890. doi:10.1001/jamasurg.2018.1674

Level 1 evidence supports neoadjuvant chemotherapy followed by a radical cystectomy (RC) for treating muscle-invasive bladder cancer (MIBC).1 Given its substantial perioperative morbidity, bladder preservation therapy (BPT) is an alternative treatment option for individuals who wish to avoid or are not able to undergo RC.2 Given the absence of prospective randomized clinical trials, well-designed observational cohort studies currently offer the best comparative effectiveness evidence to evaluate these treatment options.

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