title: Advances in the management of muscle-invasive bladder cancer through risk prediction, risk communication, and novel treatment approaches.
abstract: Although level I evidence supports the use of neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy for the management of patients with muscle-invasive bladder cancer (MIBC), these treatment modalities are utilized in only a subset of patients. The reasons for lack of implementation of these treatment standards are multiple; patients may be considered ineligible for cisplatin or too old for safe cystectomy. Better means of determining a patient's probability of recurrence with surgery alone, or likelihood of benefit with neoadjuvant chemotherapy, are clearly needed. Models have been developed to individualize estimates of non-organ-confined disease based on pretreatment variables. It is critical that clinicians are able to effectively communicate complex risk-related data to patients to facilitate a shared medical decision.
authors.affiliation: Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York 10029, USA. matthew.galsky@mssm.edu
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Galsky
authors.forename: Josep
authors.initials: J
authors.lastname: Domingo-Domenech
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use; D015653:Cystectomy; D019468:Disease Management; D006801:Humans; D019042:Muscle Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D020360:Neoadjuvant Therapy / Q000379:methods*; D009361:Neoplasm Invasiveness; D057285:Precision Medicine; D012306:Risk; D001743:Urinary Bladder / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin