There is little evidence to prove which subgroup of patients with muscle-invasive bladder cancer (MIBC) can receive partial cystectomy (PC) as an alternative to radical cystectomy (RC).

This is a retrospective cohort study. Patients with early stage MIBC (T2N0M0) who underwent RC or PC were identified from the Surveillance, Epidemiology, and End Results (SEER) database. 1:1 propensity score matching (PSM) was used to match cohorts receiving RC or PC. Kaplan–Meier analyses and log-rank tests were used to compare overall survival (OS) and cancer-specific survival (CSS) between the matched cohorts. Subgroup analyses were conducted to identify patient characteristics associated with suitability for PC treatment.

After propensity score matching (PSM), log-rank tests revealed no significant differences OS (P = 0.088) or CSS (P = 0.699) between the PC and RC cohorts. Subgroup analysis after matching demonstrated that these patients with T2a-stage, low-grade tumors or receiving chemotherapy achieved comparable OS (P = 0.629; P = 0.138; P = 0.989, respectively) and CSS (P = 0.396; P = 0.173; P = 0.260) receiving PC compared to RC. Moreover, patients with non-urothelial cancers presented significantly improved OS (P = 0.023) and CSS (P = 0.014) after receiving PC compared to RC.

Given the potential clinical benefits, patients who had T2N0M0 MIBC with T2a-stage, low-grade, non-urothelial tumors or receiving neoadjuvant therapy may be suitable for PC as an alternative to RC.