Organ-sparing trimodality therapy should be offered to all suitable patients with muscle-invasive bladder cancer, not just those who are ineligible for surgery, according to urologic oncologists.

Their recommendation is based on favourable odds of overall survival, and similar cancer-specific and disease-free survival, in patients undergoing trimodality therapy versus radical cystectomy. 

The Canadian and US doctors retrospectively analysed survival rates among 722 older adults treated for clinical stage T2-T4N0M0 muscle-invasive bladder cancer between 2005 and 2017.

About 60% of participants underwent radical cystectomy, while the rest underwent trimodality therapy with maximal transurethral resection of bladder tumour followed by concurrent chemoradiation.