Radical cystectomy versus alternative treatments for muscle-confined bladder cancer.

Of the 100 patients with muscle-confined transitional cell cancer of the bladder and ASA score < or = 3, 59 underwent radical cystectomy (RC) and 41 received non-cystectomy alternative treatments (AT). Median follow-up was 30.8 and 30.5 months in RC and in AT groups, respectively. Disease-free and overall survivals were significantly longer in RC group than AT group. Salvage cystectomy was required in approximately 25% of the patients who received AT. AT was associated with higher rate of cancer-related morbidity and cancer progression than RC. Every patient with invasive bladder cancer should be given a chance for cystectomy.