Staging and modern approaches to bladder cancer treatment

The treatment tactics for patients with superficial urothelial carcinoma and muscle-invasive bladder cancer differ significantly; therefore, diagnosis, staging and prescription of appropriate therapy remain relevant.Over a period of 5 years, follow-up data were collected on 61 cases of papillary urothelial carcinoma, 26 primary and 7 secondary muscle-invasive bladder cancer.The median recurrence-free survival in patients with transitional cell carcinoma was 4.1 years, with the greatest impact on this indicator observed for the sum of recurrence risk scores, which included tumor stage, malignancy, size, and number.Neoadjuvant polychemotherapy resulted in partial regression of malignancy according to ReCIST in only 48% of patients with muscle-invasive cancer who then underwent organ-preserving surgery.The tumor regression score correlated with the degree of malignancy and had a statistically significant effect on progression-free survival.In the remaining 52% of cases with muscle-invasive cancer, after neoadjuvant polychemotherapy, tumor growth was diagnosed as stabilised, which gave grounds for radical cystectomy.After the operation, patients reported improvement in their mental and physical condition, but the median overall survival was 3.3 years.The results obtained demonstrate the impact of tumor assessment, tumor stage and appropriate treatment on overall and recurrence-free survival in bladder cancer.