Locally advanced or oligometastatic bladder cancer—role of local treatment of the primary tumor and metastases

Abstract

Background: Treatment of muscle invasive bladder cancer can be challenging since treatment is associated with significant side effects and complication rates—especially in patients who often present with relevant comorbidities. In the metastatic stage, the purpose of treatment is palliation, although the oligometastatic stage takes a distinct role. At this stage, treatment of the primary tumor can play a role, if metastasis can be treated locally in addition to systemic treatment, especially the evolving drug treatment landscape could also change long holding paradigms in the near future. Objectives: This review focuses on the influence of definitive treatment of the primary tumor in patients with oligometastatic urothelial bladder cancer. Materials and methods: Based on a literature search, the aim was to summarize data and give an overview on treatment of oligo-metastatic bladder cancer with focus on treatment of the primary tumor. Presented data derived mostly from retrospective studies and meta-analyses. Conclusion: Local treatment of the primary tumor in context of a multimodal therapy of lymph node metastatic or oligometastatic bladder cancer can have a positive influence on survival, quality of life and prevention of local complications in selected patients. The choice of local treatment should follow the same criteria as in non-metastatic bladder cancer.