title: SEOM Clinical Guideline for treatment of muscle-invasive and metastatic urothelial bladder cancer (2016).
abstract: The goal of this article is to provide recommendations for the diagnosis and treatment of muscle-invasive and metastatic bladder cancer. The diagnosis of muscle-invasive bladder cancer is made by pathologic evaluation after transurethral resection. Recently, a molecular classification has been proposed. Staging of muscle-invasive bladder cancer must be done by computed tomography scans of the chest, abdomen and pelvis and classified on the basis of UICC system. Radical cystectomy and lymph node dissection are the treatment of choice. In muscle-invasive bladder cancer, neoadjuvant chemotherapy should be recommended in patients with good performance status and no renal function impairment. Although there is insufficient evidence for use of adjuvant chemotherapy, its use must be considered when neoadjuvant therapy had not been administered in high-risk patients. Multimodality bladder-preserving treatment in localized disease is an alternative in selected and compliant patients for whom cystectomy is not considered for clinical or personal reasons. In metastatic disease, the first-line treatment for patients must be based on cisplatin-containing combination. Vinflunine is the only drug approved for use in second line in Europe. Recently, immunotherapy treatment has demonstrated activity in this setting.
authors.affiliation: Medical Oncology Department, Hospital Álvaro Cunqueiro-Complexo Hospitalario Universitario de Vigo, Estrada Clara Campoamor, 34136312, Vigo, Spain. martin.lazaro.quintela@sergas.es.
authors.forename: M
authors.initials: M
authors.lastname: Lázaro
authors.affiliation: Medical Oncology Department, Parc Taulí Sabadell Hospital Universitari, Sabadell, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gallardo
authors.affiliation: Medical Oncology Department, Althaia, Xarxa Assisencial i Universitària de Manresa, Manresa, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Doménech
authors.affiliation: Medical Oncology Department, Hospital Universitario La Paz-Idipaz, Madrid, Spain.
authors.forename: Á
authors.initials: Á
authors.lastname: Pinto
authors.forename: A
authors.initials: A
authors.lastname: González-del-Alba
authors.affiliation: Medical Oncology Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
authors.forename: A González
authors.initials: AG
authors.lastname: Del Alba
authors.affiliation: Medical Oncology Department, Hospital Universitario San Carlos, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Puente
authors.affiliation: Complexo Hospitalario Universitario de Ourense, Badalona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Fernández
authors.affiliation: Medical Oncology Department, Germans Trias i Pujol University Hospital, Badalona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Font
authors.affiliation: Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Lainez
authors.affiliation: Medical Oncology Department, Hospital Universitario Lucus Augusti, Lugo, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Vázquez
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D006801:Humans; D018482:Muscle, Skeletal / Q000473:pathology*; D009361:Neoplasm Invasiveness; D017410:Practice Guidelines as Topic; D013030:Spain; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*
keywords: Bladder cancer; Chemotherapy; Clinical guidelines; Cystectomy