Table 1.
Survival estimates from urologists, medical oncologists and radiation oncologists for a hypothetical case scenario
| ESTIMATED 5 YEAR OVERALL SURVIVAL (%) | ||||
| CASE 1: MIBC Patient Pre Cystectomy With No Clinical Node Involvement∧ | ||||
| Cystectomy alone | NACT + Cystectomy | Cystectomy + ACT | ||
| Urologists | Mean | 55 | 64 | 57 |
| N = 110 | Median | 50 | 65 | 55 |
| Range | (25–85) | (20–95) | (20–85) | |
| Medical | Mean | 49 | 57 | 53 |
| Oncologists | Median | 50 | 57 | 53 |
| N = 47 | Range | (10–80) | (30–90) | (20–82) |
| Radiation | Mean | 51 | 58 | 55 |
| Oncologists | Median | 50 | 57 | 55 |
| N = 43 | Range | (20–75) | (30–85) | (20–80) |
| All | Mean | 53 | 61 | 56 |
| Specialists | Median | 50 | 60 | 55 |
| N = 200 | Range | (10–85) | (20–95) | (20–85) |
∧A 65 year old man presents to the Emergency Room with hematuria. Cystoscopy and biopsy shows evidence of muscle-invasive urothelial carcinoma. Staging CT scan of the chest/abdomen/pelvis and bone scan do not show any evidence of metastatic disease (imaging suggests T3 N0 disease). The patient has minimal co-morbidity, normal renal function, and is willing to follow your recommendations. What treatment options would you consider recommending for this patient?