Neoadjuvant chemotherapy in patients with invasive bladder cancer.
Neoadjuvant chemotherapy has been extensively investigated in muscle-invasive bladder cancer. When taken together, the randomized controlled trials of neoadjuvant cisplatin-based combination chemotherapy demonstrate an improved survival over cystectomy alone. In addition, neoadjuvant chemotherapy can result in downstaging of primary tumors. As noted, a pT0 disease status at cystectomy is associated with a significant improvement in survival. A randomized controlled trial comparing neoadjuvant to adjuvant cisplatin-based chemotherapy shows that neither approach is superior. Finally, the ongoing EORTC/SWOG adjuvant chemotherapy trial, when completed, should add importantly to the literature concerning the role of systemic chemotherapy in muscle-invasive bladder cancer.
Vaughn
David J
DJ
Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania School of Medicine and the Abramson Cancer Center of the University of Pennsylvania, 16 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Malkowicz
S Bruce
SB
D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D006801:Humans; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D019459:Urothelium