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Invited Commentary
June 5, 2019

Trimodal Therapy for Bladder Cancer: You Get What You Don’t Pay For

Author Affiliations
  • 1Center for Surgery and Public Health, Division of Urological Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Surg. 2019;154(8):e191637. doi:10.1001/jamasurg.2019.1637

Trimodal therapy (TMT) is a treatment option for some patients with muscle-invasive bladder cancer. This approach combines aggressive transurethral resection, radiation therapy, and radio-sensitizing chemotherapy as an alternative to radical cystectomy with urinary diversion. In the absence of head-to-head level 1 evidence, there is now a growing body of retrospective data suggesting worse survival rates with this technique.1,2 Now added to this are data suggesting higher costs as well.3

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