Anesthesia Modality and Oncologic Outcomes in High-Risk NMIBC: A Randomized Trial

Inclusion Criteria: * Age ≥40 years for male subjects or postmenopausal female subjects * ECOG performance status 0-2 * Patients with suspected or newly diagnosed UBUC * ASA I or II * Patients with any other adequately treated Stage I or II cancer except UC, from which the subject has been disease free for 5 years * Adequate renal function, defined as a serum creatinine (Cre) concentration ≤ the institutional ULN * Adequate hepatic function, defined as total bilirubin ≤ the institutional ULN and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ the institutional upper limit of normal (ULN) Exclusion Criteria: * Patients with prior or concurrent UC involving the renal pelvis, ureter or urethra * Patients with clinical evidence of MIBC or mUC * Immunocompromised or immunosuppressed patients * Patients with chronic use of anti-inflammatory agents or beta-blockers * Patients with difficult airways or other significant cardiovascular comorbidities (severe aortic stenosis, significant pulmonary disease, CHF) who are intolerant to GA * Patients with elevated intracranial pressure (ICP), primarily due to intracranial mass and trauma or infection at the site of SA * Patients with a serious uncontrolled medical disorder (e.g., trauma, fracture) or active infection that would impair their ability to receive spinal or GA * Patients with known allergies to propofol, fentanyl, sevoflurane, or bupivacaine * Subjects with a known history or family history of malignant hyperthermia * Subjects with bleeding diathesis