Résumé

Introduction: Bladder cancer is the eleventh most common cancer worldwide and is an increasing public health concern, particularly in North Africa. Radical cystectomy remains a standard treatment for muscle-invasive disease, but bladder-preserving strategies may be considered in selected patients. Methods: We conducted a retrospective single-center study at the Mohammed VI Center in Casablanca involving 109 patients with pT2N0–1M0 urothelial carcinoma treated between January 2015 and December 2019. Treatment combined maximal transurethral resection of the bladder tumor, neoadjuvant gemcitabine–cisplatin chemotherapy, and subsequent concurrent chemoradiotherapy. Results: Mean age was 63.15 years and mean follow-up was 30.94 months. At last follow-up, 88 patients (80.7%) were alive and 21 (19.3%) had died. Fifteen recurrences were recorded, including 13 with a documented time to recurrence. Ureterohydronephrosis was associated with shorter overall survival (p = 0.006). Severe toxicities were uncommon, and all patients completed radiotherapy. Conclusion: This quadrimodal strategy yielded encouraging outcomes and may provide a bladder-preserving option for carefully selected patients. Prospective comparative studies are required.

Mot-clés :

Urothelial Carcinoma; Bladder; Quadrimodal Treatment; Bladder Preservation