AUA Guidelines: Treatment Of Non - Metastatic Muscle - Invasive Bladder Cancer

Guest: Jeffrey M Holzbeierlein, MD

Outline:

Segment #1: Guideline Statement 9-Patients who have not received cisplatin-based NAC and have pT3-4 and/or N= disease at cystectomy should receive adjuvant cisplatin based chemotherapy or adjuvant immunotherapy.

Segment #2: Guideline Statement 11-When performing a cystectomy in males the bladder, prostate cand seminal vesicles should be removed (no change) but in females clinicians should consider removal of adjacent reproductive organs based on individual disease characteristics and need to obtain negative margins. Organ sparing procedures in females should be considered based on disease location and characteristics on an individual basis.

Segment #3: Guideline Statement 20-When performing bilateral pelvic lymphadenectomy , clinicians should remove, at a minimum, the external and internal iliac and obturator lymph nodes (standard lymphadenectomy).

Segment #4: Future Directions

Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: AUA/ASCO/ASTRO/SUO Guideline

Holzbeierlein J, Bixler BR, Buckley DI, et al. Treatment of non-metastatic muscle-invasive bladder cancer: AUA/ASCO/SUO guideline (2017; amended 2020, 2024). J Urol. Published online April 25, 2024. doi:10.1097/JU.0000000000003981 https://www.auajournals.org/doi/10.1097/JU.0000000000003981