How do you approach elective nodal irradiation in muscle-invasive bladder cancer?

The evidence regarding elective nodal irradiation (ENI) in patients undergoing organ preservation with chemotherapy and radiation is mixed, especially when considering data from surgical studies. A meta-analysis involving approximately 17,000 patients indicated that nodal dissection improved outcome...

ENI unless there is a reason not to

Great comments! As pointed out, BC2001 without any nodal RT, only 10 pelvic nodal failures (out of 219 patients) were reported granted the vast majority of patients had T2N0 disease.

An NCDB retrospective study looking at 2,000+ cN0 MIBC who completed CRT also did not appreciate any difference in OS...

Retrospective surgical studies suggest a survival benefit to a lymph node dissection versus cystectomy alone (e.g., Abdollah et al., PMID 21883849), although, to my knowledge, this has never been validated prospectively. Multiple retrospective surgical studies have also suggested that more extensive...