Juan H. Chipollini, MD, FACS, presented “Counterpoint: Radical Cystectomy for Muscle Invasive Bladder Cancer” during the 31st Annual Perspectives in Urology: Point-Counterpoint, on October 18, 2024, in Scottsdale, Arizona.
How to cite: Chipollini, Juan H. “Counterpoint: Radical Cystectomy for Muscle Invasive Bladder Cancer.” October 18, 2024. Accessed Feb 2025. https://grandroundsinurology.com/counterpoint-radical-cystectomy-for-muscle-invasive-bladder-cancer/
Counterpoint: Radical Cystectomy for Muscle Invasive Bladder Cancer – Summary
In this 12-minute presentation, Juan H. Chipollini, MD, FACS, provides an in-depth analysis of bladder-preserving approaches for muscle-invasive bladder cancer (MIBC).
Emphasizing the role of patient selection, Dr. Chipollini highlights the effectiveness of bladder preservation for medically unfit patients and those delaying treatment due to personal or access issues. Limitations include tumor location, size, and histological factors, as well as a paucity of prospective trials and biomarkers. The lack of clarity between clinical and pathologic complete response is also addressed.
Dr. Chipollini critiques key studies, such as a multi-institutional retrospective trial with 722 MIBC patients, comparing trimodality therapy (TMT) and cystectomy. The trial shows equivalent cancer-specific and metastasis-free survival, yet selection bias and the predominance of T2 disease limit generalizability. He underscores the need for multidisciplinary care and rigorous follow-up to optimize outcomes for bladder-preserving treatments. Surgical outcomes, including 83% five-year cancer-specific survival and low surgical mortality, are noted as benchmarks for cystectomy. Dr. Chipollini advocates for shared decision-making, ensuring patients are treated at centers equipped for both bladder-preserving therapies and post-radiation cystectomy.
About the 31st Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
ABOUT THE AUTHOR
Juan J. Chipollini, MD, FACS, is an Urologic Oncologist and Associate Professor in the Department of Urology at the University of Arizona College of Medicine, in Tucson, Arizona. Dr. Chipollini has research interests involving novel diagnostic biomarkers in urothelial carcinoma. He also studies health disparities in the surgical management of renal cell and penile cancer patients.
Dr. Chipollini graduated Summa Cum Laude from the University of Arkansas with a degree in Biophysical Chemistry. He completed his medical education at the University of Arkansas for Medical Sciences where he graduated with honors. He finished General Surgery internship and Urology residency at the University of Miami Miller School of Medicine. He went on to complete a Society of Urologic Oncology-accredited fellowship at the H. Lee Moffitt Cancer Center and Research Institute where he specialized in the management of urologic malignancies using both complex as well as minimally-invasive surgery.
Dr. Chipollini has extensive experience with the Da Vinci robotic platform to treat renal, bladder, and prostate malignancies. He also leads in the surgical management of locally-advanced renal cell carcinoma and urologic cancers involving the retroperitoneum. He has an active surgical practice as the only university-based academic urologic oncologist in the state of Arizona, and is principal investigator in several clinical trials at the NCI-designated University of Arizona Cancer Center.
