Mednet Logo
HomeQuestion

How do you manage a bladder cancer patient who had a partial cystectomy with a positive margin?

4
3 Answers
Mednet Member
Mednet Member
Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty

In fewer than 5% of bladder cancer patients, partial cystectomy along with neoadjuvant cisplatin-based chemotherapy can be considered for stage II (cT2, N0) disease with a single tumor in a suitable location and no presence of carcinoma in situ, where an adequate margin of soft tissue and an adequat...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · Levine Cancer Institute

Admittedly, I have not seen this precise situation. Presumably, that is because surgeons rarely perform partial cystectomy (radical is the standard of care). If they did and had a positive margin, presumably they would complete the radical and be done. Overall, my enthusiasm for "adjuvant" RT in thi...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · UW Carbone Cancer Center

As just one option for an otherwise poor-risk patient, which seems very plausible, given the similar toxicities in the accelerated doses of the RAIDER trial, one could consider dose escalation to 70 Gy (assuming optimal bladder location away from abutting bowel), with modified accelerated dose in fi...

Register or Sign In to see full answer