Defining optimal therapy for muscle invasive bladder cancer Journal Article


Authors: Herr, H. W.; Dotan, Z.; Donat, S. M.; Bajorin, D. F.
Article Title: Defining optimal therapy for muscle invasive bladder cancer
Abstract: Purpose: We defined an optimal curative strategy for muscle invasive bladder cancer and to determine how best to deliver curative therapy. Materials and Methods: We reviewed published reports from 1985 to 2006 dealing with the treatment of muscle invasive (stage T2-T4a) bladder cancer. We analyzed all cohort, phase II and randomized phase III studies providing level 1 to 3 evidence impacting survival. Results: Cisplatin based chemotherapy combined with high quality radical cystectomy and complete pelvic lymph node dissection improves survival over that of cystectomy alone. Surgery quality is an important predictor of survival even in patients receiving chemotherapy. Neoadjuvant chemotherapy is favored over adjuvant chemotherapy because it is better tolerated and more patients are able to receive effective therapy before rather than after surgery. Conclusions: Neoadjuvant chemotherapy followed by radical cystectomy and complete pelvic lymph node dissection is the optimal curative strategy in most patients presenting with muscle invasive bladder cancer.
Keywords: survival; cisplatin; chemotherapy; methotrexate; neoplasm; radical cystectomy; cystectomy; urothelial carcinoma; bladder neoplasms; neoadjuvant chemotherapy; drug therapy; bladder; individual patient data; transitional-cell-carcinoma; randomized-trial; adjuvant; inuasiveness; m-vac
Journal Title: Journal of Urology
Volume: 177
Issue: 2
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2007-02-01
Start Page: 437
End Page: 443
Language: English
ACCESSION: WOS:000243453900005
DOI: 10.1016/j.juro.2006.09.027
PROVIDER: wos
PUBMED: 17222605
Notes: --- - Review - "Source: Wos"
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MSK Authors
  1. Zohar A Dotan
    19 Dotan
  2. Dean Bajorin
    404 Bajorin
  3. Sherri M Donat
    135 Donat
  4. Harry W Herr
    401 Herr