What Role for Radical Cystectomy for Muscle-Invasive Bladder Cancer?

In the U.S., radical cystectomy has long been considered the standard of care for patients with muscle-invasive bladder cancer. However, radical cystectomy (with or without the creation of an orthotopic diversion) is a complex surgical procedure requiring intensive perioperative support services, and most patients with muscle-invasive disease are older than 70. During the past 2 decades, patients treated at academic centers have increasingly undergone radical cystectomy, whereas those treated in community settings have increasingly received alternate therapies such as radiation or chemotherapy.

Now, researchers have examined Surveillance, Epidemiology, and End Results–Medicare data to assess factors associated with the use of radical cystect…