Urologie pro praxi 4/2017

Neoadjuvant chemotherapy for muscle-invasive bladder cancer

Radical cystectomy with pelvic lymph node dissection is a standard of treatment for muscle-invasive bladder cancer. However, no major improvement of oncological results was seen in the last 30 years. The multimodal therapy was introduced to achieve better survival of the patients. The muscle-invasive bladder cancer started to be considered a systemic disease as 30–50% of cT2–4N0 tumors have occult metastatic disease at the time of radical cystectomy. Based on experience with palliative chemotherapy for metastatatic disease, cisplatin-based perioperative chemotherapy was introduced into treatment algorithm of muscle-invasive tumors. In these patients, randomized trials with neoadjuvant chemotherapy showed a 5 % benefit in overall survival.

Keywords: muscle invasive bladder cancer, radical cystectomy, neoadjuvant chemotherapy.