title: Comprehensive surgical and chemotherapy treatment for invasive bladder cancer.
abstract: BACKGROUND
  The treatment of transitional cell bladder cancer with muscular invasion remains difficult, due to the numerous patterns of biological behaviour of the disease. There is controversy regarding the application of systemic therapy in invasive bladder carcinoma and the ideal time for the indication of perioperative chemotherapy. This is an overview of systemic therapy in invasive bladder cancer.
  
  
  METHODS
  Using MEDLINE, we reviewed relevant English and Spanish literature published during the last five years, with "chemotherapy in bladder cancer" as keywords. We selected randomised trials, meta-analyses and clinical trials.
  
  
  RESULTS
  We obtained 241 articles, 31 of which referred to neoadjuvant and adjuvant chemotherapy in invasive bladder cancer. We classified the articles into three different groups: neoadjuvant, adjuvant and neoadjuvant plus chemotherapy. This information is shown in the tables within the text.
  
  
  CONCLUSIONS
  A multidisciplinary approach to the treatment of invasive bladder cancer is essential to guarantee adequate oncological control. Detailed evaluation and proper selection of each patient is fundamental in determining the best moment to start chemotherapy.
authors.affiliation: Department of Urology, Montsouris Institute, Université Paris Descartes, Paris, France.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sánchez-Salas
authors.forename: Gemma I
authors.initials: GI
authors.lastname: Duque Ruiz
authors.forename: John
authors.initials: J
authors.lastname: Watson
authors.forename: Eugenio
authors.initials: E
authors.lastname: Rocha
authors.forename: Eric
authors.initials: E
authors.lastname: Barret
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
authors.forename: Francois
authors.initials: F
authors.lastname: Rozet
authors.forename: Marc
authors.initials: M
authors.lastname: Galiano
authors.forename: Guy
authors.initials: G
authors.lastname: Vallancien
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*