Radiothérapie périopératoire dans la prise en charge des tumeurs urothéliales infiltrantes de la vessie (TVIM) : une indication à reconsidérer ?

Despite the rise of neo-adjuvant chemotherapy in the management of muscle invasive bladder cancer (MIBC), locoregional recurrence (LRR) is an early event impacting the oncological outcome of patients treated with radical cystectomy and pelvic lymph-node dissection. Data from surgical series have defined the frequency and preferential sites of this LRR. Risk stratification based on pathological findings was established. Historically, perioperative radiotherapy has been evaluated but the radiation technique used failed to validate the toxicity involved in this strategy. Modern techniques, such as intensity-modulated and image-guided radiotherapy, could lead to reconsider the indication of adjuvant radiotherapy with limited dose to adjacent healthy organs. New prospective trials evaluating the benefit of this approach should be undertaken. [ABSTRACT FROM AUTHOR]