Bladder-Sparing Treatment Approach for Large Non-Muscle-Invasive Bladder Cancer Comparing Maximal TURBT with Chemotherapy and Immunotherapy Versus Immediate Radical Cystectomy

What this Trial Is About

Bladder cancer is a common urinary system cancer, with a significant number of patients diagnosed with non-muscle-invasive bladder cancer NMIBC. NMIBC varies in risk based on tumor size, stage, and grade, and while surgery is primary treatment, residual tumors and recurrence are concerns, especially for larger tumors. This research aims to explore bladder-sparing treatment strategies for large-volume NMIBC, balancing quality of life with cancer control outcomes. The study compares two approaches a bladder-sparing set and immediate radical cystectomy. The bladder-sparing method involves neoadjuvant chemotherapy combined with immunotherapy, followed by maximal transurethral resection of bladder tumor TURBT and a second TURBT, then mitomycin C bladder instillation therapy. The radical cystectomy group undergoes surgery immediately after three cycles of neoadjuvant therapy. Participants will be monitored from enrollment through three years after treatment, focusing on recurrence-free survival as the main outcome. Progression-free survival is also measured. Regular follow-up will assess tumor status and safety. The study includes adults aged 18 to 80 who can tolerate chemotherapy and immunotherapy and are willing to comply with study requirements, including ongoing evaluations and bladder instillation therapy.

A Bladder-Sparing Treatment Strategies of Large-Volume Non-Muscle-Invasive Bladder Cancer