Follow-up strategies after trimodal treatment for muscle-invasive bladder cancer: a systematic review

Ernest Kaufmann¹, Stefanie Aeppli², Winfried Arnold³, Panagiotis Balermpas⁴, Jörg Beyer⁵, Uwe Bieri^{6

7}, Richard Cathomas⁸, Berardino de Bari⁹, Marco Dressler¹⁰, Daniel S Engeler¹¹, Andreas Erdmann¹², Andrea Gallina¹³, Silvia Gomez¹⁴, Matthias Guckenberger⁴, Thomas R W Herrmann^{15

16

17}, Thomas Hermanns¹⁸, Lucca Ilaria¹⁹, Hubert John²⁰, Thomas M Kessler²¹, Jan Klein^{22

23}, Mohamed Laouiti²⁴, David Lauffer²⁵, Agostino Mattei¹, Michael Müntener²⁶, Daniel Nguyen²⁷, Philipp Niederberger²⁸, Alexandros Papachristofilou²⁹, Lukas Prause³⁰, Karsten Reinhardt³¹, Emanuela Salati³², Philippe Sèbe³³, Mohamed Shelan³⁴, Räto Strebel³⁵, Arnoud J Templeton³⁶, Ursula Vogl³⁷, Marian S Wettstein³⁸, Deborah Zihler³⁹, Thomas Zilli⁴⁰, Daniel Zwahlen⁴¹, Beat Roth⁴², Christian Fankhauser⁴³

Affiliations

¹ Department of Urology, University of Lucerne, Luzerner Kantonsspital, Spitalstrasse, 6000, 16, Lucerne, Switzerland.
² Department of Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
³ Department of Radiation-Oncology, Luzerner Kantonsspital, Lucerne, Switzerland.
⁴ Department of Radiation-Oncology, Universitiy Hospital Zurich, Zurich, Switzerland.
⁵ Department of Oncology, Inselspital Bern, Berne, Switzerland.
⁶ Department of Urology, Kantonsspital Baden, Baden, Switzerland.
⁷ Department of Urology, University Hospital Zurich, Zurich, Switzerland.
⁸ Department of Oncology, Kantonsspital Chur, Chur, Switzerland.
⁹ Department of Radiation-Oncology, Réseau Hospitalier Neuchâtelois, Neuchâtel, Switzerland.
¹⁰ Zentrum Für Onkologie Luzern, Lucerne, Switzerland.
¹¹ Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
¹² Department of Oncology, Kantonsspital Baden, Baden, Switzerland.
¹³ Department of Urology, EOC Ente Ospedaliero Cantonale, Lugano, Switzerland.
¹⁴ Department of Radiation-Oncology, Kantonsspital Aarau, Aarau, Switzerland.
¹⁵ Department of Urology, Spital Thurgau AG, Kantonsspital Frauenfeld, Frauenfeld, Switzerland.
¹⁶ Division of Urology, Department of Surgical Sciences, Stellenbosch University, Western Cape, South Africa.
¹⁷ Hannover Medical School, Hannover, Germany.
¹⁸ Zentrum für Urologie Zürich, Zurich, Switzerland.
¹⁹ Department of Urology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
²⁰ Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland.
²¹ Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
²² Department of Urology, Kantonsspital Münsterlingen, Müsterlingen, Switzerland.
²³ Department of Urology, Medical School, Ulm, Germany.
²⁴ Department of Radiation-Oncology, Hôpital Riviera Chablais, Rennaz, Switzerland.
²⁵ Department of Radiation-Oncology, University Hospital Geneva, Geneva, Switzerland.
²⁶ Department of Urology, Stadtspital Triemli, Zurich, Switzerland.
²⁷ Department of Urology, Réseau Hospitalier Neuchâtelois, Neuchâtel, Switzerland.
²⁸ Department of Oncology, Luzerner Kantonsspital, Lucerne, Switzerland.
²⁹ Department of Radiation-Oncology, University Hospital Basel, Basel, Switzerland.
³⁰ Department of Urology, Kantonsspital Aarau, Aarau, Switzerland.
³¹ Department of Urology, St. Clara Hospital Basel, Basel, Switzerland.
³² Department of Oncology, Hôpital Riviera Chablais, Rennaz, Switzerland.
³³ Department of Urology, University Hospital Geneva, Geneva, Switzerland.
³⁴ Department of Radiation-Oncology, Inselspital Bern, Berne, Switzerland.
³⁵ Department of Urology, Kantonsspital Chur, Chur, Switzerland.
³⁶ Department of Oncology, St. Claraspital Basel and Faculty of Medicine, University Basel, Basel, Switzerland.
³⁷ Department of Oncology, EOC Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
³⁸ Department of Uro-Oncology, University of Toronto, Toronto, Canada.
³⁹ Department of Oncology, Kantonsspital Aarau, Aarau, Switzerland.
⁴⁰ Department of Radiation-Oncology, EOC Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
⁴¹ Department of Radiation-Oncology, Kantonsspital Winterthur, Winterthur, Switzerland.
⁴² Department of Urology, Inselspital Bern, Berne, Switzerland.
⁴³ Department of Urology, University of Lucerne, Luzerner Kantonsspital, Spitalstrasse, 6000, 16, Lucerne, Switzerland. cdfankhauser@gmail.com.

PMID: 39297968
PMCID: PMC11413066
DOI: 10.1007/s00345-024-05196-7

Follow-up strategies after trimodal treatment for muscle-invasive bladder cancer: a systematic review

Ernest Kaufmann et al. World J Urol. 2024.

. 2024 Sep 19;42(1):527.

doi: 10.1007/s00345-024-05196-7.

Authors

Affiliations

¹ Department of Urology, University of Lucerne, Luzerner Kantonsspital, Spitalstrasse, 6000, 16, Lucerne, Switzerland.
² Department of Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
³ Department of Radiation-Oncology, Luzerner Kantonsspital, Lucerne, Switzerland.
⁴ Department of Radiation-Oncology, Universitiy Hospital Zurich, Zurich, Switzerland.
⁵ Department of Oncology, Inselspital Bern, Berne, Switzerland.
⁶ Department of Urology, Kantonsspital Baden, Baden, Switzerland.
⁷ Department of Urology, University Hospital Zurich, Zurich, Switzerland.
⁸ Department of Oncology, Kantonsspital Chur, Chur, Switzerland.
⁹ Department of Radiation-Oncology, Réseau Hospitalier Neuchâtelois, Neuchâtel, Switzerland.
¹⁰ Zentrum Für Onkologie Luzern, Lucerne, Switzerland.
¹¹ Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
¹² Department of Oncology, Kantonsspital Baden, Baden, Switzerland.
¹³ Department of Urology, EOC Ente Ospedaliero Cantonale, Lugano, Switzerland.
¹⁴ Department of Radiation-Oncology, Kantonsspital Aarau, Aarau, Switzerland.
¹⁵ Department of Urology, Spital Thurgau AG, Kantonsspital Frauenfeld, Frauenfeld, Switzerland.
¹⁶ Division of Urology, Department of Surgical Sciences, Stellenbosch University, Western Cape, South Africa.
¹⁷ Hannover Medical School, Hannover, Germany.
¹⁸ Zentrum für Urologie Zürich, Zurich, Switzerland.
¹⁹ Department of Urology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
²⁰ Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland.
²¹ Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
²² Department of Urology, Kantonsspital Münsterlingen, Müsterlingen, Switzerland.
²³ Department of Urology, Medical School, Ulm, Germany.
²⁴ Department of Radiation-Oncology, Hôpital Riviera Chablais, Rennaz, Switzerland.
²⁵ Department of Radiation-Oncology, University Hospital Geneva, Geneva, Switzerland.
²⁶ Department of Urology, Stadtspital Triemli, Zurich, Switzerland.
²⁷ Department of Urology, Réseau Hospitalier Neuchâtelois, Neuchâtel, Switzerland.
²⁸ Department of Oncology, Luzerner Kantonsspital, Lucerne, Switzerland.
²⁹ Department of Radiation-Oncology, University Hospital Basel, Basel, Switzerland.
³⁰ Department of Urology, Kantonsspital Aarau, Aarau, Switzerland.
³¹ Department of Urology, St. Clara Hospital Basel, Basel, Switzerland.
³² Department of Oncology, Hôpital Riviera Chablais, Rennaz, Switzerland.
³³ Department of Urology, University Hospital Geneva, Geneva, Switzerland.
³⁴ Department of Radiation-Oncology, Inselspital Bern, Berne, Switzerland.
³⁵ Department of Urology, Kantonsspital Chur, Chur, Switzerland.
³⁶ Department of Oncology, St. Claraspital Basel and Faculty of Medicine, University Basel, Basel, Switzerland.
³⁷ Department of Oncology, EOC Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
³⁸ Department of Uro-Oncology, University of Toronto, Toronto, Canada.
³⁹ Department of Oncology, Kantonsspital Aarau, Aarau, Switzerland.
⁴⁰ Department of Radiation-Oncology, EOC Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
⁴¹ Department of Radiation-Oncology, Kantonsspital Winterthur, Winterthur, Switzerland.
⁴² Department of Urology, Inselspital Bern, Berne, Switzerland.
⁴³ Department of Urology, University of Lucerne, Luzerner Kantonsspital, Spitalstrasse, 6000, 16, Lucerne, Switzerland. cdfankhauser@gmail.com.

PMID: 39297968
PMCID: PMC11413066
DOI: 10.1007/s00345-024-05196-7

Abstract

Purpose: Optimal follow-up strategies following trimodal treatment for muscle invasive bladder cancer play a crucial role in detecting and managing relapse and side-effects. This article provides a comprehensive summary of the patterns and risk factors of relapse, functional outcomes, and follow-up protocols.

Methods: A systematic literature search on PubMed and review of current guidelines and institutional follow-up protocols after trimodal therapy were conducted.

Results: Out of 200 identified publications, 43 studies (28 retrospective, 15 prospective) were selected, encompassing 7447 patients (study sizes from 24 to 728 patients). Recurrence rates in the urinary bladder varied between 14-52%; 3-16% were muscle-invasive while 11-36% were non-muscle invasive. Nodal recurrence occurred at 13-16% and distant metastases at 15-35%. After 5 and 10 years of follow-up, around 60-85% and 45-75% of patients could preserve their bladder, respectively. Various prognostic risk factors associated with relapse and inferior survival were proposed, including higher disease stage (> c/pT2), presence of extensive/multifocal carcinoma in situ (CIS), hydronephrosis, multifocality, histological subtypes, incomplete transurethral resection of bladder tumor (TURBT) and incomplete response to radio-chemotherapy. The analyzed follow-up guidelines varied slightly in terms of the number, timing, and types of investigations, but overall, the recommendations were similar.

Conclusion: Randomized prospective studies should focus on evaluating the impact of specific follow-up protocols on oncological and functional outcomes following trimodal treatment for muscle-invasive bladder cancer. It is crucial to evaluate personalized adaption of follow-up protocols based on established risk factors, as there is potential for improved patient outcomes and resource allocation.

Keywords: Bladder preservation; Follow-up; Functional outcomes; Oncological outcomes; Trimodal treatment; Trimodality.

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Conflict of interest statement

The authors declare no competing interests.

References

1. Lenis AT, Lec PM, Chamie K, Mshs MD (2020) Bladder cancer: a review. JAMA 324:1980–1991. 10.1001/jama.2020.17598 - PubMed
1. Catto JWF, Downing A, Mason S, Wright P, Absolom K, Bottomley S et al (2021) Quality of life after bladder cancer: a cross-sectional survey of patient-reported outcomes. Eur Urol 79:621–632. 10.1016/j.eururo.2021.01.032 - PMC - PubMed
1. Mak KS, Smith AB, Eidelman A, Clayman R, Niemierko A, Cheng JS et al (2016) Quality of life in long-term survivors of muscle-invasive bladder cancer. Int J Radiat Oncol Biol Phys 96:1028–1036. 10.1016/j.ijrobp.2016.08.023 - PubMed
1. James ND, Hussain SA, Hall E, Jenkins P, Tremlett J, Rawlings C et al (2012) Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med 366:1477–1488. 10.1056/NEJMoa1106106 - PubMed
1. Softness K, Kaul S, Fleishman A, Efstathiou J, Bellmunt J, Kim SP et al. (2022) Radical cystectomy versus trimodality therapy for muscle-invasive urothelial carcinoma of the bladder. Urol Oncol. 40: 272. 10.1016/j.urolonc.2021.12.015 - PubMed

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Follow-up strategies after trimodal treatment for muscle-invasive bladder cancer: a systematic review

Affiliations

Follow-up strategies after trimodal treatment for muscle-invasive bladder cancer: a systematic review

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical