Integration of neoadjuvant and adjuvant chemotherapy and cystectomy in the treatment of muscle-invasive bladder cancer Journal Article
| Authors: | Milowsky, M. I.; Stadler, W. M.; Bajorin, D. F. |
| Article Title: | Integration of neoadjuvant and adjuvant chemotherapy and cystectomy in the treatment of muscle-invasive bladder cancer |
| 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. © 2008 The Authors. |
| Keywords: | cancer survival; treatment outcome; treatment response; retrospective studies; review; bevacizumab; cisplatin; doxorubicin; sunitinib; monotherapy; clinical trials as topic; gemcitabine; paclitaxel; adjuvant therapy; cancer radiotherapy; chemotherapy, adjuvant; neoadjuvant therapy; chemotherapy; methotrexate; lymph node dissection; pelvis lymph node; prospective studies; biological marker; carboplatin; metastasis; multiple cycle treatment; antineoplastic combined chemotherapy protocols; combination chemotherapy; cyclophosphamide; bladder cancer; urinary bladder neoplasms; cancer mortality; vinblastine; risk; patient care; folinic acid; adjuvant chemotherapy; cystectomy; epirubicin; neoplasm invasiveness; carcinoma, transitional cell; transitional cell carcinoma; urothelial cancer; neoadjuvant; adjuvant |
| Journal Title: | BJU International |
| Volume: | 102 |
| Issue: | 9B |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2008-11-01 |
| Start Page: | 1339 |
| End Page: | 1344 |
| Language: | English |
| DOI: | 10.1111/j.1464-410X.2008.07980.x |
| PUBMED: | 19035902 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 4" - "Export Date: 17 November 2011" - "CODEN: BJINF" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work