López Valcárcel, MartaBarrado Los Arcos, MartaFerri Molina, MaríaCienfuegos Belmonte, IreneDuque Santana, VíctorGajate Borau, PabloFernández Ibiza, JaimeÁlvarez Maestro, MarioCouñago Lorenzo, FelipeEt al.2024-11-162024-11-162024López Valcárcel, M., Barrado Los Arcos, M., Ferri Molina, M., Cienfuegos Belmonte, I., Duque Santana, V., Gajate Borau, P., Fernández Ibiza, J., Álvarez Maestro, M., Sargos, P., López Campos, F., & Couñago, F. (2024). Is trimodal therapy the current standard for muscle-invasive bladder cancer?. Actas Urológicas Españolas, 48(5), 345–355. https://doi.org/10.1016/j.acuroe.2024.04.0010210-48061699-7980http://hdl.handle.net/11268/13213Objective: The aim of this review is to summarize the current evidence and future perspectives of bladder-sparing treatment for MIBC. Methods: A non-systematic literature search in Medline/Pubmed was performed in October 2023 with the following keywords "bladder cancer", "bladder-sparing", "trimodal therapy", "chemoradiation", "biomarkers", "immunotherapy", "neoadjuvant chemotherapy", "radiotherapy". Results: Urology guidelines recommend radical cystectomy as the standard curative treatment for muscle-invasive urothelial bladder cancer, reserving radiotherapy for patients who are unfit or who want to preserve their bladder. Given the morbidity and mortality of cystectomy and its impact on quality of life and bladder function, modern oncologic therapies are increasingly oriented toward organ preservation and maximizing functional outcomes while maintaining treatment efficacy. Trimodal therapy, which incorporates maximal transurethral resection followed by radiotherapy with concurrent radiosensitizing chemotherapy, is an effective regimen for bladder function preservation in well-selected patients. Despite the absence of comparative data from randomized trials, the two approaches seem to provide comparable oncologic outcomes. Studies are evaluating the expansion of eligibility criteria for trimodal therapy, the optimization of radiotherapy and immunotherapy delivery to further improve outcomes, and the validation of biomarkers to guide bladder preservation. Conclusions: Trimodal therapy has shown acceptable outcomes for bladder preservation; therefore, it provides a valid treatment option in well-selected patients.engVejiga urinariaQuimioterapiajournal article10.1016/j.acuroe.2024.04.001restricted accessCáncerTerapiaGoal 3: Ensure healthy lives and promote well-being for all at all ages