title: [Neoadjuvant or Adjuvant Chemotherapy for Bladder Cancer?].
abstract: Advanced urothelial carcinoma of the bladder is associated with a high metastatic potential. Life expectancy for metastatic patients is poor and rarely exceeds more than one year without further therapy. Neoadjuvant chemotherapy can decrease the tumour burden while reducing the risk of death. Adjuvant chemotherapy has been discussed controversially. Patients with lymph node-positive metastases seem to benefit the most from adjuvant chemotherapy. In selected patients, metastasectomy can prolong survival. In metastastic patients, the combination of gemcitabine and cisplatin has become the new standard regimen due to a lower toxicity in comparison to the combination of methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC). For second-line treatment, vinflunine is the only approved therapeutic agent.
authors.affiliation: Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover.
authors.forename: M C
authors.initials: MC
authors.lastname: Hupe
authors.affiliation: Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover.
authors.forename: M W
authors.initials: MW
authors.lastname: Kramer
authors.affiliation: Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover.
authors.forename: M A
authors.initials: MA
authors.lastname: Kuczyk
authors.affiliation: Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover.
authors.forename: A S
authors.initials: AS
authors.lastname: Merseburger
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D059146:Metastasectomy; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*