Curious about the case challenges? Compare yourself with your peers, and challenge the RENALC-BLADDR-PROSCA faculty.
Wilma, 69 years old, still cooks traditional Dutch meals every Sunday, but she always ends dessert with ‘stroopwafels’ warmed over tea for her grandchildren. She says it is a small tradition that keeps everyone at the table a little longer.
She recently underwent cystoscopy for painless haematuria, revealing a papillary bladder tumour. Her past medical history includes stable coronary artery disease, hypertension and borderline diabetes. She quit smoking 25 years ago.
Assessment summary:
- Diagnostic TURBT, pathological review:
- At least pT2 urothelial carcinoma (UCa)
- Unifocal, no concomitant carcinoma in situ (CIS)
- Imaging: suggestive for cT3N0M0
- Ultrasound: no hydronephrosis
- CrCl: 66 ml/min
- No peripheral neuropathy
- No hearing impairment
- ECOG PS: 0
- Cardiac ejection fraction: 62%
The multidisciplinary tumour board assessed that the patient is a candidate for RC + PLND.
Regulatory approval and local restrictions aside, which option would you suggest for Ines?
(click on the option you would recommend & scroll down to compare your answer with Dr. Thomas Powles)
B. Neoadjuvant full dose gemcitabine + cisplatin (GC)
C. Neoadjuvant full dose GC + perioperative durvalumab
D. Neoadjuvant split dose GC + perioperative durvalumab
Wilma, 69 years old, still cooks traditional Dutch meals every Sunday, but she always ends dessert with ‘stroopwafels’ warmed over tea for her grandchildren. She says it is a small tradition that keeps everyone at the table a little longer.
She recently underwent cystoscopy for painless haematuria, revealing a papillary bladder tumour. Her past medical history includes stable coronary artery disease, hypertension and borderline diabetes. She quit smoking 25 years ago.
Assessment summary:
- Diagnostic TURBT, pathological review:
- At least pT2 urothelial carcinoma (UCa)
- Unifocal, no concomitant carcinoma in situ (CIS)
- Imaging: suggestive for cT3N0M0
- Ultrasound: no hydronephrosis
- CrCl: 66 ml/min
- No peripheral neuropathy
- No hearing impairment
- ECOG PS: 0
- Cardiac ejection fraction: 62%
The multidisciplinary tumour board assessed that the patient is a candidate for RC + PLND.
Regulatory approval and local restrictions aside, which option would you suggest for Ines?
(click on the option you would recommend & scroll down to compare your answer with Dr. Thomas Powles)