title: Contemporary management of muscle-invasive bladder cancer.
abstract: The current standard treatment for muscle-invasive nonmetastatic bladder cancer is neoadjuvant platinum-based chemotherapy followed by radical cystectomy. However, neoadjuvant chemotherapy is not widely accepted even with level 1 evidence. Adjuvant chemotherapy should be discussed if patients have not received neoadjuvant chemotherapy before surgery and have high-risk pathologic features. Although not considered standard of care, bladder-sparing therapy can be considered for highly selected patients and for those medically unfit for surgery. Even though there are no level 1 data, the treatment outcomes for highly select patients given bladder-sparing therapy appear promising, with many patients retaining a functional bladder. Personalized chemotherapy is currently being actively pursued to target the underlying molecular changes and tailor to individual needs.
authors: Department of Urology, University of California Davis, 4860 Y Street, Suite 3500, Sacramento, CA 95817, USA. marc.dallera@ucdmc.ucdavis.edu
authors: Marc A
authors: MA
authors: Dall'Era
authors: Liang
authors: L
authors: Cheng
authors: Chong-Xian
authors: CX
authors: Pan
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D059186:Chemoradiotherapy, Adjuvant / Q000706:statistics & numerical data; D002945:Cisplatin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin