title: Bladder cancer.
abstract: Bladder cancer is a complex disease associated with high morbidity and mortality rates if not treated optimally. Awareness of haematuria as the major presenting symptom is paramount, and early diagnosis with individualised treatment and follow-up is the key to a successful outcome. For non-muscle-invasive bladder cancer, the mainstay of treatment is complete resection of the tumour followed by induction and maintenance immunotherapy with intravesical BCG vaccine or intravesical chemotherapy. For muscle-invasive bladder cancer, multimodal treatment involving radical cystectomy with neoadjuvant chemotherapy offers the best chance for cure. Selected patients with muscle-invasive tumours can be offered bladder-sparing trimodality treatment consisting of transurethral resection with chemoradiation. Advanced disease is best treated with systemic cisplatin-based chemotherapy; immunotherapy is emerging as a viable salvage treatment for patients in whom first-line chemotherapy cannot control the disease. Developments in the past 2 years have shed light on genetic subtypes of bladder cancer that might differ from one another in response to various treatments.
authors.affiliation: Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: akamat@mdanderson.org.
authors.forename: Ashish M
authors.initials: AM
authors.lastname: Kamat
authors.affiliation: Departments of Oncology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Noah M
authors.initials: NM
authors.lastname: Hahn
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Efstathiou
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Seth P
authors.initials: SP
authors.lastname: Lerner
authors.affiliation: Department of Surgical Sciences, Urology, Uppsala University, Uppsala, Sweden.
authors.forename: Per-Uno
authors.initials: PU
authors.lastname: Malmström
authors.affiliation: Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Woonyoung
authors.initials: W
authors.lastname: Choi
authors.affiliation: Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Guo
authors.affiliation: Department of Urology, University of Texas Southwestern, Dallas, TX, USA.
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
authors.affiliation: Department of Surgery (Urology), McGill University Health Center, Montreal, QC, Canada.
authors.forename: Wassim
authors.initials: W
authors.lastname: Kassouf
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D015653:Cystectomy / Q000379:methods; D018572:Disease-Free Survival; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D007167:Immunotherapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin