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Bladder Cancer Treatment (PDQ®)

  • Updated: 02/21/2014

Table 7. Standard Treatment Options for Bladder Cancer

Stage (TNM Staging Criteria)  Standard Treatment Options  
BCG = bacillus Calmette-Guérin; EBRT = external-beam radiation therapy; TUR = transurethral resection.
Stage 0 Bladder CancerTUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy
TUR with fulguration
TUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy followed by periodic intravesical instillations of BCG
TUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy followed by intravesical chemotherapy
Segmental cystectomy (rarely indicated)
Radical cystectomy (in rare, highly selected patients with extensive or refractory superficial high-grade tumors)
Stage I Bladder CancerTUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy
TUR with fulguration
TUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy followed by periodic intravesical instillations of BCG
TUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy followed by intravesical chemotherapy
Segmental cystectomy (rarely indicated)
Radical cystectomy in selected patients with extensive or refractory superficial tumors
Stages II and III Bladder CancerRadical cystectomy
Neoadjuvant combination chemotherapy followed by radical cystectomy
EBRT with or without concomitant chemotherapy
Segmental cystectomy (in selected patients)
TUR with fulguration (in selected patients)
Stage IV Bladder CancerT4b, N0, M0 and any T, N1–N3, M0Chemotherapy alone
Radical cystectomy
Radical cystectomy followed by chemotherapy
Radical cystectomy alone
EBRT with or without concomitant chemotherapy
Urinary diversion or cystectomy for palliation
Any T, any N, M1Chemotherapy alone or as an adjunct to local treatment
EBRT for palliation
Urinary diversion or cystectomy for palliation
Recurrent Bladder CancerCombination chemotherapy