SUMMARY
The aim of the present study was to perform a comparative analysis of long-term oncological outcomes following radical cystectomy (RC) and trimodal therapy (TMT) in patients with muscle-invasive bladder cancer (MIBC), as well as to develop a prognostic model for predicting recurrence after RC. Material and methods. A total of 359 patients with MIBC were included in the study, of whom 257 underwent RC and 102 received TMT. Survival analysis was performed using the Kaplan–Meier method, while prognostic factors were assessed using the Cox proportional hazards regression model. Results. In the RC group, the 5-year recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) rates were 63.1%, 65.3%, and 54.1%, respectively. In the TMT group, the 5-year CSS and OS rates were 33.7% and 31.4%, respectively. The risk of cancer-specific mortality was significantly higher in patients treated with TMT compared with RC (HR=2.37; 95% CI 1.73–3.25; p<0.001). Independent predictors of unfavorable prognosis following RC included tumor stage, lymph node involvement, histological tumor type, Charlson Comorbidity Index, and surgical team experience. Based on these variables, a nomogram predicting 1- and 3-year recurrence-free survival was developed, demonstrating high prognostic accuracy (c-index=0.834). Conclusion. The obtained results confirm the superiority of radical cystectomy as the standard treatment modality for MIBC. Nevertheless, in carefully selected patients with favorable prognostic characteristics, oncological outcomes following TMT were comparable to those observed after RC.
Keywords: bladder cancer, muscle-invasive bladder cancer, radical cystectomy, trimodal therapy, survival, nomogram

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