At EAU 2025, Dr. Marco Moschini addresses the debate on the required extent of TURBT for muscle-invasive bladder cancer (MIBC). He explains that the surgical approach depends on the patient’s treatment plan.
Transcript
Interviewer
Welcome everybody to the EAU 25 in Madrid, Spain. My name is David Anderer, urologist from Vienna, Austria, and my distinguished pleasure to welcome a close friend of mine, Marco Moschini, urologist from the Vita-Salute University in Milano, Italy. Marco, thank you very much for your time and for being with us today.
Interviewer
Marco, can you, uh, share with us, uh, with you some thoughts about the extent of TURB in muscle-invasive bladder cancer? It’s been a matter of debate for a long time. Is a single biopsy enough or is the complete resection of the tumor leading to some advantages in terms of disease control, oncologic outcomes? What are your thoughts about?
Dr. Marco Moschini
Well, you have to consider several different clinical scenario that we have as urologists and we face every day with our patient with muscle-invasive bladder cancer. The first is when you consider the patient a good candidate for neoadjuvant chemotherapy and then radical cystectomy, I think that the data are strong enough suggesting that you do not need to complete the TURBT. You just need to have a good specimen with the clear, um, pathological evaluation of the muscle invasion and then also data regarding variant histology and the other pathological feature.
Dr. Marco Moschini
If you are trying to, um, offer to your patient a trimodal therapy is completely another story. I think that the patient might benefit from a complete TURBT, a complete resection.
Dr. Marco Moschini
But then also if you consider all the new trial, offering perioperative immuno and perioperative chemotherapy to this patient with the idea of potentially save the bladder from the radical treatment, cystectomy or trimodal therapy is crucial to perform a complete TURBT and to being able to measure also the way you did the TURBT before starting the systemic treatment.
Interviewer
Excellent, thank you very much. This was very clear. So, one approach fits all does not exist also in this case. We have to do have a discussion with the patient and, uh, of course, the clinical features of the tumor drive then the the final decision. Thank you very much for being with us and wish you a pleasant congress.
Dr. Marco Moschini
Thank you.
