Perioperative Therapy and Surgical Recovery in MIBC

This episode, titled “Perioperative Therapy and Surgical Recovery in MIBC,” features panelists discussing how newer perioperative systemic therapies are affecting surgical recovery, tissue healing, and postoperative management in muscle-invasive bladder cancer (MIBC). The expert urologic oncology faculty review operative video cases and discuss how immunotherapy- and antibody-drug conjugate-based regimens are influencing tissue planes, lymph node dissection, urinary diversion outcomes, and postoperative recovery following radical cystectomy.

Throughout the discussion, the panel highlights that although some patients may demonstrate localized fibrosis or desmoplastic reactions surrounding previously involved lymph nodes, many operative planes remain favorable and surgical approaches can still be performed safely and effectively. The faculty emphasize that perioperative therapies have not significantly altered core surgical principles or diversion selection, and that wound healing, bowel recovery, and urinary diversion outcomes appear comparable to historical experiences with traditional chemotherapy.

The panelists also explore how patients treated with newer systemic therapies may experience less treatment-related frailty, sarcopenia, and nutritional decline prior to surgery compared with traditional cisplatin-based chemotherapy. In addition, the discussion examines whether these differences may contribute to faster postoperative recovery, shorter hospital stays, and improved functional status following radical cystectomy.

Finally, the faculty emphasize the importance of continued multicenter collaboration and prospective clinical trials to better define the perioperative and postoperative effects of emerging therapies in MIBC. The panel discusses how ongoing research efforts will be critical for refining surgical management and optimizing recovery in patients receiving newer perioperative treatment approaches.

In the next episode, “Multidisciplinary Management in the Perioperative Era of MIBC,” panelists will discuss how newer perioperative treatment strategies are influencing referral patterns, multidisciplinary collaboration, and clinical workflows in muscle-invasive bladder cancer. The panel will also highlight challenges associated with patient selection, bladder-sparing surveillance, and coordination of care across specialties.