title: [Value of systemic chemotherapy in bladder cancer].
abstract: Almost half of the patients with muscle invasive disease already harbor at the time of their first diagnosis occult or distant metastases. Systemic disease has a poor prognosis with a long term survival of less than 10%. The administration of systemic chemotherapy aims to improve the course of locally advanced or metastatic disease.A survival benefit of 5% for patients receiving neoadjuvant and 9-11% using adjuvant chemotherapy is in the first scenario minimal, in the adjuvant setting to be noteworthy. The MVAC-schedule and the Gemcitabine/Cisplatin-combination chemotherapy have to be regarded as standard for induction chemotherapy. However, the 5-year survival rates with 15 or 13% are disappointing.Thus, prognostic factors gain importance since with their consideration significant differences in survival rates can be found. Hope is provided by a novel class of substances, the target-specific drugs, which selectively interfere with the cascade of steps involved in tumorigenesis.
authors.affiliation: Westdeutsches Tumorzentrum (WTZE), Essen, Germany. peter.goebell@uni-essen.de
authors.forename: P J
authors.initials: PJ
authors.lastname: Goebell
authors.forename: F
authors.initials: F
authors.lastname: vom Dorp
authors.forename: H
authors.initials: H
authors.lastname: Rübben
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004358:Drug Therapy / Q000379:methods* / Q000639:trends; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality*
chemical_list: D000970:Antineoplastic Agents