A 67-year-old man, a former smoker, presented with gross hematuria. A CT urogram showed a bladder tumor in the anterior wall and multiple enlarged retroperitoneal lymph nodes. Two vertebral metastases were seen on a bone scan. He underwent a transurethral resection of the bladder, and the pathology report revealed muscle-invasive urothelial carcinoma.
In patients with stage II to III urothelial carcinoma, bladder-preservation therapy was associated with poorer overall survival compared with radical cystectomy, according to a database study.