“AUA2023 Panel Discussion: Bladder Preservation for a 75-year-old with a focal T2 UCC: RC, TUR +/- Chemo, Chemo-Rads” is the case scenario presentation that Drs Michael Poch, MD; Sophia Kamran, MD; and Jeannie Hoffman-Censits, MD, will discuss in a panel format. Combining evidence-based comments with clinical experience, the panel members will address 2 fundamental questions: (1) What is the optimal therapy for this patient? and (2) If bladder-sparing therapy is the chosen treatment, what is the optimal way to deliver this treatment?

Initially, the specific patient and disease characteristics that help formulate the appropriate plan for patients with muscle-invasive bladder cancer will be discussed. The multidisciplinary team approach will be emphasized. Understanding the interplay between many clinical factors will help determine the appropriateness of bladder-sparing treatment. The panel will then focus on the different therapeutic approaches available other than radical cystectomy. A guideline-based review of the pros and cons of these approaches will be outlined as well as current clinical trials examining different systemic approaches combined with radiation therapy. The current state-of-the-art protocol for patients desiring bladder sparing multi-modality therapy will be presented, as will be the important role of salvage cystectomy for patients desiring bladder preservation. Also included will be specific and clinically relevant “how to” descriptions that will benefit clinicians. Provocative questions regarding difficult clinical situations will then be asked of the panel members, who will weigh in with their opinions.

This panel will provide an up-to-date standard of therapy for patients with bladder cancer and will aid in patient selection for bladder preservation.