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Cicione et al. Mini-invasive Surg 2021;5:47 https://dx.doi.org/10.20517/2574-1225.2021.52 Page 9 of 11

CONCLUSION
Salvage radical cystectomy is performed both after failure of conservative treatment for muscle invasive
bladder cancer and as a palliative surgery in the case of intractable and fatal complications such as
hematuria. An appropriate selection of patients suited for TMT leads to acceptable outcomes, whereas the
rate of major complications (CCS ≥ 3) in the case of a subsequent SRC is higher than the one previously
[41]
reported for RC . Furthermore, during patient counseling for TMT, the high probability of receiving an
incontinent urinary diversion in the future instead of an orthotopic neobladder in the case of immediate RC
should be underlined. In the absence of comparative studies able to identify risk factors for TMT failure, a
multidisciplinary cooperation and close follow-up is required. Likewise, SRC for symptom relief should be
considered only if there are no other options and after an accurate assessment of patient frailty through the
currently available questionnaires such as ASA score Charlson Index, Karnofsky scale, and Geriatric-8
currently able to estimate patient’s vulnerability to stress factors such as surgery.

DECLARATIONS
Authors’ contributions
Data research and manuscript drafting: Cicione A, Lombardo R, Voglino OA
Manuscript revision: Tubaro A, De Nunzio C

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2021.

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