Randomized trials of adjuvant and neoadjuvant chemotherapy in bladder cancer.
Data of randomized studies of adjuvant and neoadjuvant chemotherapy for patients with muscle-invasive bladder cancer were reviewed. Four adjuvant studies have been published. The interpretation of their data is compromised primarily because of small patient numbers. Thus, a possible survival advantage cannot be documented, and significantly larger, prospective studies are needed. However, there is some evidence of improved disease-free survival for patients with non-organ-confined tumors treated with cisplatin-based combination chemotherapy. More data are available for neoadjuvant chemotherapy. The already published randomized studies, including a large trial of who was designed to detect a 10% survival benefit, do not indicate a significant advantage for neoadjuvant chemotherapy. Radical cystectomy remains the standard treatment to which other therapeutic modalities must be compared.
Department of Clinical Therapeutics, University of Athens School of Medicine, Greece.
M A
MA
Dimopoulos
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E
Galani
D017024:Chemotherapy, Adjuvant; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*