Partial Cystectomy for Bladder Cancer: A Systematic Review of Oncologic Outcomes and Patient Selection
Matheus Castro de Almeida, Pedro Filipe Gomes, Miellio Melo Galdino, Matheus Pascotto de Salles, Thiago Sipas Teixeira Luz, Frederico Timóteo Silva Cunha, José Henrique Dallacqua Santiago, Sidney Glina, Fernando KorkesBackground:
Bladder preservation strategies are a possibility for a selected group of patients with muscle-invasive bladder cancer (MIBC), aiming to lower morbidity but intending to obtain similar cure rates. Partial cystectomy (PC) has been historically one of these bladder preservation strategies. However, criteria are not consensual between authors and guidelines. This study evaluates the main factors associated with indications, outcomes, and postoperative care of PC to treat urothelial carcinoma through a systematic review of the literature.
Methods:
MEDLINE, Embase, and Scopus were systematically reviewed for articles published from January 1980 to August 2025. All relevant studies that included PC for the treatment of urothelial bladder cancer were considered. Primary outcomes were defined as overall survival (OS), cancer-specific survival, need for salvage radical cystectomy, and metastasis-free survival. Patients and tumor characteristics, indications, and outcomes were also evaluated.
Results:
Systematic search yielded 5301 citations that ultimately resulted in 31 studies that met inclusion criteria, comprising 8666 patients. PC was performed in strictly selected candidates—solitary, organ-confined (≤T2) urothelial tumors measuring ≤ 3 to 5 cm, located in resectable areas of the bladder (typically dome or lateral wall), without carcinoma in situ, hydronephrosis, or upper tract involvement. When applied under these criteria, PC achieved favorable oncologic outcomes, with 5-year OS ranging from 57% to 91%, cancer-specific survival from 72% to 100%, and recurrence-free survival from 39% to 97%. Salvage radical cystectomy was required in ≤ 6% of contemporary series.
Conclusion:
PC is a modality of bladder-sparing approach to nonmetastatic MIBC that has been performed in very distinctive situations for highly selected patients. Despite the variation in the indication criteria, studies report that PC is being performed with good short-term and long-term oncological outcomes. It is essential to better understand the outcomes after precise indications and ancillary treatments to improve medical knowledge.