Approach to initial therapy for muscle-invasive bladder cancer

ECOG: Eastern Cooperative Oncology Group; NYHA: New York Heart Association; RT: radiation therapy; TURBT: transurethral resection of bladder tumor.

* Tumor stage is assessed using cystoscopy, biopsy, systemic imaging, and other testing as clinically indicated. Refer to UpToDate content on diagnosis and staging of bladder cancer.

¶ Various treatment options are available for metastatic disease either as single agents or in combination, such as platinum-based chemotherapy, immunotherapy, targeted therapy, and antibody-drug conjugates. For further details, refer to UpToDate content on treatment of metastatic urothelial carcinoma of the bladder and urinary tract.

Δ Refer to UpToDate content on bladder preservation treatment options for muscle-invasive urothelial bladder cancer.

◊ For select patients with high-risk disease after radical cystectomy, adjuvant therapy (eg, chemotherapy, immunotherapy, radiation) is an option. Refer to UpToDate content on adjuvant therapy for muscle-invasive urothelial carcinoma bladder.