Background: Muscle invasive bladder cancer is a frequent disease in Germany. The accepted therapy of choice is radical cystectomy. Due to comorbidities, radical removal of the bladder is often associated with increased perioperative morbidity; therefore alternatives to a radical procedure should be offered.
Objectives: Overview and description of focal therapeutic concepts in muscle invasive bladder cancer to provide therapeutic alternatives for radical organ removal.
Materials and methods: Database research, analysis and discussion of clinical trials presenting therapeutic concepts for focal therapy in muscle invasive bladder cancer.
Results: High-energy shock waves, high-intensity focused ultrasound and laser therapy are experimental concepts for muscle invasive bladder cancer. Transurethral resection and radiotherapy in combination with chemotherapy, where appropriate, are available as focal therapy in bladder cancer.
Conclusions: Cystectomy is the accepted therapy for muscle invasive bladder cancer. Several therapeutic procedures are available as focal therapy. In selected cases, focal therapy can offer an alternative therapy in muscle invasive bladder cancer.
Keywords: Bladder cancer; Focal therapy; Organ-sparing treatments; Radical surgery; Radiotherapy.