title: Management of patients with muscle-invasive and metastatic bladder cancer.
abstract: Bladder cancer is the fifth most common cancer diagnosed in the United States. Prognosis for this disease is dependent on both tumor stage and grade. Radical cystectomy has been the standard treatment for muscle-invasive local disease; however, combined-modality approaches with the use of chemotherapy are gaining momentum with data suggesting survival improvement. Patients with metastatic disease have poor long-term survival rates despite systemic multiagent chemotherapy. A variety of agents, including newer cytotoxic drugs and biologically targeted agents, are under investigation to determine the most effective regimen. The special needs of specific patient populations, such as the elderly, those with a suboptimal performance status, and patients with medical comorbidities have gained more attention. Progress in the treatment of this disease is dependent on supporting ongoing and future clinical trials.
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan 48109-0946, USA.
authors.forename: N Lynn
authors.initials: NL
authors.lastname: Henry
authors.forename: Gary
authors.initials: G
authors.lastname: MacVicar
authors.forename: Maha
authors.initials: M
authors.lastname: Hussain
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015897:Comorbidity; D015653:Cystectomy; D006801:Humans; D008197:Lymph Node Excision; D019042:Muscle Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents