Function Sparing Approaches With Chemotherapy and Conservative Surgery

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Herr et al. further championed the potential for bladder preservation in highly selected patients in a study that examined the role of neo-adjuvant M-VAC chemotherapy after aggressive TUR, and subsequent surgical consolidation via partial cystectomy in a select group of patients that had lesions amenable to this approach.8 In this series, 26 of 111 patients were considered to be candidates for partial cystectomy after TUR and M-VAC chemotherapy. The pre-treatment stage of these patients included 19 T2 and seven > T3 tumours. After reviewing the partial cystectomy specimens, the authors noted that 77% of patients were downstaged to <T1 and there was a 47% p0 rate. Overall, the five-year disease-free survival was 65%, and

Table 1: Published series on bladder preservation with chemotherapy and conservative surgery.


Number of patients


Response (CR)


Bladder preservation


Srougi (1994)9

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