Aditya Bagrodia, MD, FACS, presented “Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer – Cystectomy” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
How to cite: Bagrodia, Aditya. “Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer – Cystectomy.” March 10, 2023. Accessed Jul 2024. https://grandroundsinurology.com/point-counterpoint-cystectomy-vs-trimodal-therapy-for-muscle-invasive-bladder-cancer-cystectomy/
Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer – Cystectomy – Summary
Aditya Bagrodia, MD, FACS, discusses the standard treatment for muscle-invasive bladder cancer, cystectomy, focusing on the effectiveness of cystectomy in comparison to trimodal therapy. He highlights the weaknesses of trimodal therapy, focusing on the importance of selecting highly suitable candidates for trimodal therapy, emphasizing factors such as tumor size, absence of extra bladder disease, proper bladder function, and lymph node evaluation.
Dr. Bagrodia presents data from German and Mass General Hospital experiences, demonstrating the negative outcomes of trimodal therapy. The results show that while trimodal therapy can achieve disease-free status in about two-thirds of patients initially, a significant proportion may require subsequent treatment, including cystectomy. Cancer-specific and overall survival rates at 10 years vary depending on the extent of the disease, with more advanced stages showing a decline in outcomes. The study also compares these outcomes to those of cystectomy, highlighting the higher recurrence-free survival rates associated with organ-confined disease and the potential benefits of neoadjuvant chemotherapy.
Overall, the data suggests that highly selected patients receiving cystectomy may have better outcomes compared to those receiving trimodal therapy. However, individual patient characteristics and preferences should be considered when deciding the most appropriate treatment approach.
This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer–Trimodal Therapy.”
About the 30th 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
Aditya Bagrodia, MD is an Associate Professor and genitourinary oncology disease team leader in the Department of Urology at UC San Diego Health.
Dr. Bagrodia earned his medical degree from the University of Tennessee Health Sciences Center, graduating with highest honors. He was awarded a Doris Duke Clinical Research Fellowship in clinical research at UT Southwestern Medical Center where he completed his residency in urology. Dr. Bagrodia completed a fellowship in urologic oncology at Memorial Sloan Kettering Cancer Center, where he received an American Urological Association Urology Care Foundation Research Scholars Grant.
Dr. Bagrodia’s clinical practice comprises all urologic malignancies including adrenal, upper tract, renal, bladder, prostate, penile, and testicular cancers. He has expertise in complex multidisciplinary management and minimally invasive approaches to urologic surgery.
Dr. Bagrodia’s clinical and research focus is on patients with germ cell tumors. His laboratory centers on sequencing efforts to understand tumor evolution and heterogeneity in germ cell tumors as well as to identify novel biomarkers to recognize occult metastatic disease. On the clinical side, Dr. Bagrodia is actively involved with understanding and overcoming unique socio-epidemiological considerations that adversely impact oncologic outcomes in patients with germ cell tumors. He is also the principal investigator for several germ cell tumor-directed clinical trials.
Dr. Bagrodia has conducted extensive research in urologic oncology, primarily in biomarker profiles and molecular signatures of urologic tumors as predictors of clinical outcomes. He is funded through competitive grants from the Cancer Prevention and Research Institute of Texas (CPRIT), intramural grants, and NIH funding.
Dr. Bagrodia is the principal author or co-author of more than 190 articles, including more than 50 articles devoted to germ cell tumors, in peer-reviewed publications such as the Journal of Clinical Oncology, Nature Genetics, European Urology, and the Journal of Urology. He is also the co-host of Backtable Urology, a podcast devoted to the practical education of urology providers.
