Treatment of muscle-infiltrating bladder cancer

Last updated: 16/10/2019

Background

Bladder cancer is the fourth most common cancer in men with a 5-year survival rate of less than 40% for patients diagnosed with muscle-infiltrating bladder cancer (MIBK). Curative treatment options aim to heal the patient and in this case include removal of the entire bladder (radical cystectomy), possibly supplemented with chemotherapy, and bladder-preserving trimodality treatment. 

Trimodality treatment includes complete removal of the bladder tumour (TURB), radiation and chemotherapy. If the disease proves to be incurable, suitable patients may be treated medically with chemotherapy or immunomodulatory drugs (checkpoint inhibitors) to stagnate the course of the disease. Radiation therapy and surgery (TURB) can be used to relieve bothersome symptoms from the bladder. Radiation therapy can also be used for symptomatic metastatic tumors.

There is a lack of studies describing the scope and type of curative and palliative care as MIBK patients receive in Norway (both nationally and regionally) and its importance for their disease survival. It is also currently unknown if it matters whether a bladder cancer patient is diagnosed with MIBK at initial diagnosis (primary MIBK) or whether the disease has developed from a non-muscle-infiltrating bladder cancer (subsequent MIBK) with regard to treatment choices and survival.

Project purpose

This registry-based study includes all bladder cancer patients with an MIBK diagnosis between 2008 and 2016. Our aim of this study is to elucidate which and extent of the treatments MIBK patients, diagnosed during the last decade of Norway, receive and associated prognosis. Furthermore, we will investigate whether there is any difference between primary and subsequent MIBK with regard to choice of treatment and prognosis. The results will have great significance for clinicians treating MIBK patients, future treatment strategies and follow-up of MIBK patients in Norway.