Integration of neoadjuvant and adjuvant chemotherapy and cystectomy in the treatment of muscle‐invasive bladder cancer
- 15 October 2008
- journal article
- review article
- Published by Wiley in BJU International
- Vol. 102 (9b), 1339-1344
- https://doi.org/10.1111/j.1464-410x.2008.07980.x
Abstract
Bladder cancer is a potentially curable malignancy but for those patients who present with or develop muscle-invasive disease, there is a high risk of metastases and cancer-related death. The treatment of patients with muscle-invasive bladder cancer uses a multimodal approach, including radical cystectomy with pelvic lymph node dissection and perioperative chemotherapy. Neoadjuvant cisplatin combination chemotherapy has a modest survival benefit, with those patients achieving a complete pathological response after chemotherapy having the best outcome. Adjuvant chemotherapy, although less well substantiated, is a reasonable option for patients with extravesical disease or lymph node involvement after cystectomy. Perioperative chemotherapy is substantially underused despite the level-1 evidence showing a survival benefit. Ongoing research will focus on individualized patient care, with biomarkers to predict a pathological complete response and the development of novel targeted therapies.Keywords
This publication has 37 references indexed in Scilit:
- Cancer Statistics, 2007CA: A Cancer Journal for Clinicians, 2007
- Evaluation of the Relevance of Lymph Node Density in a Contemporary Series of Patients Undergoing Radical CystectomyJournal of Urology, 2006
- Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder CancerJournal of Clinical Oncology, 2005
- UPDATE ON CHEMOTHERAPY FOR ADVANCED BLADDER CANCERJournal of Urology, 2005
- IMPACT OF THE NUMBER OF LYMPH NODES RETRIEVED ON OUTCOME IN PATIENTS WITH MUSCLE INVASIVE BLADDER CANCERJournal of Urology, 2002
- POST-CHEMOTHERAPY SURGERY IN PATIENTS WITH UNRESECTABLE OR REGIONALLY METASTATIC BLADDER CANCERJournal of Urology, 2001
- Original Articles: Bladder Cancer: Neoadjuvant Cisplatin Chemotherapy Before Radical Cystectomy in Invasive Transitional Cell Carcinoma of the Bladder: A Prospective Randomized Phase III StudyJournal of Urology, 1995
- A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study.Journal of Clinical Oncology, 1992
- Neo-adjuvant (Pre-emptive) Cisplatin Therapy in Invasive Transitional Cell Carcinoma of the BladderBritish Journal of Urology, 1991
- A prospective randomized trial comparing MVAC and CISCA chemotherapy for patients with metastatic urothelial tumors.Journal of Clinical Oncology, 1990