The goal of this observational study is to evaluate the safety and efficacy of neoadjuvant therapy followed by bladder - preserving TMT in patients with MIBC. The main question it aims to answer is: Does this treatment model improve long - term outcomes, including survival, local control, distant metastasis, and bladder preservation rates? Participants who received neoadjuvant therapy and underwent TMT for bladder preservation will be observed.
None
None
Histopathologically confirmed bladder cancer (T2-T4aN0-2M0, 8th edition AJCC staging). Underwent bladder - sparing TMT following neoadjuvant therapy (ADC, immunotherapy, or chemotherapy). Aged ≥18 years. Signed an informed consent form. Good general condition with ECOG performance status of 0-2. Adequate organ function for chemoradiotherapy: (1) Hematology: Absolute neutrophil count ≥1.5×10⁹/L, platelets ≥100×10⁹/L, hemoglobin ≥90 g/L. (2) Liver function: Total bilirubin ≤1.5×ULN, ALT and AST ≤2.5×ULN (≤5×ULN if hepatic metastasis is present). (3) Renal function: Creatinine clearance ≥30 mL/min (via Cockcroft-Gault formula).
Cohort
Prospective
NA-TMT
RadiationAfter neoadjuvant therapy, patients choose trimodality therapy (TMT) for bladder preservation over radical cystectomy.
DFS
OS
BI - EFS
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