title: Managing locally advanced bladder cancer.
abstract: Locally advanced bladder cancer comprising tumor stages pT3a, pT3b, pT4a of the 1997 TNM system and/or involvement of regional lymph nodes can be cured by radical cystectomy. However, at least 50% of patients experience systemic progression within 5 years after surgery. In order to improve the fate of these patients, the administration of additional therapy has been studied in various forms, such as neoadjuvant and adjuvant systemic chemotherapy, as well as combined radiochemotherapy. Results from more than a dozen randomized Phase III trials on adjunctive chemotherapy, which include cystectomy as definite treatment have been reported. Whether neoadjuvant or adjuvant systemic chemotherapy is the superior form of adjunctive therapy for locally advanced bladder cancer continues to be a matter of dispute.
authors.affiliation: Department of Urology and Pediatric Urology, Saarland University, Kirrberger Strasse, 66421 Homburg/Saar, Germany. jan.lehmann@uniklinik-saarland.de
authors.forename: Jan
authors.initials: J
authors.lastname: Lehmann
authors.forename: Margitta
authors.initials: M
authors.lastname: Retz
authors.forename: Stefan
authors.initials: S
authors.lastname: Siemer
authors.forename: Jörn
authors.initials: J
authors.lastname: Kamradt
authors.forename: Bernd
authors.initials: B
authors.lastname: Wullich
authors.forename: Michael
authors.initials: M
authors.lastname: Stöckle
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D006801:Humans; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents