Treatment of muscle-invasive bladder cancer in patients without comorbidities and fit for surgery: Trimodality therapy vs radical cystectomy. Development of GRADE (Grades of Recommendation, Assessment, Development and Evaluation) recommendation by the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Giulio Francolini, Simona Borghesi, Sergio Fersino, Alessandro Magli, Barbara Alicja Jereczek-Fossa, Luca Cristinelli, Mimma Rizzo, Renzo Corvò, Giovanni L Pappagallo, Stefano Arcangeli, Stefano Maria Magrini, Rolando M D'Angelillo

Research output: Contribution to journalReview articlepeer-review

Abstract

AIM: To compare trimodality therapy (TMT) versus radical cystectomy (RC) and develop GRADE (Grades of Recommendation, Assessment, Development and Evaluation) Recommendation by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) for treatment of muscle-invasive bladder cancer (MIBC).

MATERIAL AND METHODS: Prospective and retrospective studies comparing TMT and RC for MIBC patients were included. Qualitative and quantitative evaluation of evidence was made.

RESULTS: Ten studies were included in the analysis. Pooled analysis showed salvage cystectomy and pathological complete response rates after TMT of 12 % and 72-77.5 %, respectively. Pooled rates of G3-G4 GU toxicity and serious toxicity rate were 18 vs 3% and 45 vs 29 % for patients undergoing TMT vs RC, respectively. The panel assessed a substantial equivalence in terms of OS and CSS at 5 years between TMT and RC.

CONCLUSIONS: TMT could be suggested as an alternative treatment to RC in non-metastatic MIBC patients, deemed fit for surgery.

Original languageEnglish
Pages (from-to)103235
Number of pages8
JournalCritical Reviews in Oncology/Hematology
Volume159
DOIs
Publication statusPublished - Mar 2021

Keywords

  • Cystectomy
  • Humans
  • Italy/epidemiology
  • Medical Oncology
  • Muscles
  • Neoplasm Invasiveness
  • Prospective Studies
  • Retrospective Studies
  • Treatment Outcome
  • Urinary Bladder Neoplasms/epidemiology

Fingerprint

Dive into the research topics of 'Treatment of muscle-invasive bladder cancer in patients without comorbidities and fit for surgery: Trimodality therapy vs radical cystectomy. Development of GRADE (Grades of Recommendation, Assessment, Development and Evaluation) recommendation by the Italian Association of Radiotherapy and Clinical Oncology (AIRO)'. Together they form a unique fingerprint.

Cite this