Open AccessMuscle-Invasive Bladder Cancer in Patients with Liver Cirrhosis: A Review of Pertinent Considerations
Author(s) -
John Kim,
Harkanwal Randhawa,
David Sands,
Shahid Lambe,
Marco Puglia,
Pablo E. Serrano,
Jehonathan H. Pinthus
Publication year - 2021
Publication title -
bladder cancer
Language(s) - English
Resource type - Journals
eISSN - 2352-3735
pISSN - 2352-3727
DOI - 10.3233/blc-211536
Subject(s) - medicine , cirrhosis , bladder cancer , perioperative , cancer , incidence (geometry) , liver cancer , population , intensive care medicine , surgery , gastroenterology , physics , environmental health , optics
The incidence of liver cirrhosis is increasing worldwide. Patients with cirrhosis are generally at a higher risk of harbouring hepatic and non-hepatic malignancies, including bladder cancer, likely due to the presence of related risk factors such as smoking. Cirrhosis can complicate both the operative and non-surgical management of bladder cancer. For example, cirrhotic patients undergoing abdominal surgery generally demonstrate worse postoperative outcomes, and chemotherapy in patients with cirrhosis often requires dose reduction due to its direct hepatotoxic effects and reduced hepatic clearance. Multiple other considerations in the peri-operative management for cirrhosis patients with muscle-invasive bladder cancer must be taken into account to optimize outcomes in these patients. Unfortunately, the current literature specifically related to the treatment of cirrhotic bladder cancer patients remains sparse. We aim to review the literature on treatment considerations for this patient population with respect to perioperative, surgical, and adjuvant management.