AUTHOR'S REPLY

Abstract

Cent European J Urol 2015; 68: 17 doi: 10.5173/ceju.2015.01.r95 Although bladder tumors can be considered as a common disease by any experienced urologist, their management remains a challenge for anyone trying to take into account every new study or additional data which continually brings significant changes. Our study was focused on evaluating the delay between the last TURBT and radical cystectomy (RC) in several countries, even though some of the causes of this sometime long delay were not entirely analyzed [1]. It is, however, obvious that there is no standardized approach to the surgical treatment of bladder cancer, probably due to many conflicting data on different therapies. Our original paper was born from the idea that a shorter time between endoscopy and radical surgery is beneficial for the patient and so we decided to get real life data on how this aspect was managed in our countries. There seems to be a consensus that a 3 months interval remains safe for performing a cystectomy, but even this parameter is challenged by some authors [2]. There are many reasons leading to this delay, some of them being beyond the borders of medical science, and so we will not comment on those. But considering some medical reasons that might induce a delay, two major situations appear to be more frequent. The first aspect is the neoadjuvant chemotherapy, recommended by the guidelines as an option, regardless of the stage or other features of the tumor. There are many ongoing studies trying to revolutionize the treatment of bladder cancer by imposing a neoadjuvant chemotherapy as a mandatory step before radical surgery [3], but such evidence needs a long period of time to maCristian Persu1, Sławomir Poletajew2