Maximizing cure for muscle-invasive bladder cancer: Integration of surgery and chemotherapy Journal Article
| Authors: | Feifer, A. H.; Taylor, J. M.; Tarin, T. V.; Herr, H. W. |
| Article Title: | Maximizing cure for muscle-invasive bladder cancer: Integration of surgery and chemotherapy |
| Abstract: | Context: The optimal treatment strategy for muscle-invasive bladder cancer remains controversial. Objective: To determine optimal combination of chemotherapy and surgery aimed at preserving survival of patients with locally advanced bladder cancer. Evidence acquisition: We performed a critical review of the published abstract and presentation literature on combined modality therapy for muscle-invasive bladder cancer. We emphasized articles of the highest scientific level, combining radical cystectomy and perioperative chemotherapy with curative intent to affect overall and disease-specific survival. Evidence synthesis: Locally invasive, regional, and occult micrometastases at the time of radical cystectomy lead to both distant and local failure, causing bladder cancer deaths. Neoadjuvant and adjuvant chemotherapy regimens have been evaluated, as well as the quality of cystectomy and pelvic lymph node dissection. Conclusions: Prospective, randomized clinical trials argue strongly for neoadjuvant cisplatin-based chemotherapy followed by high-quality cystectomy performed by an experienced surgeon operating in a high-volume center. Adjuvant chemotherapy after surgery is also effective when therapeutic doses can be given in a timely fashion. Both contribute to improved overall survival; however, many patients receive only one or none of these options, and the barriers to receiving optimal, combined, systemic therapy and surgery remain to be defined. An aging, comorbid, and often unfit population increasingly affected by bladder cancer poses significant challenges in management of individual patients. © 2011 European Association of Urology. |
| Keywords: | cancer survival; cancer surgery; treatment failure; overall survival; drug tolerability; neutropenia; review; cisplatin; doxorubicin; advanced cancer; cancer combination chemotherapy; drug efficacy; unspecified side effect; gemcitabine; paclitaxel; cancer adjuvant therapy; cancer patient; chemotherapy; methotrexate; recurrent cancer; lymph node dissection; pelvis lymph node; prospective study; mucosa inflammation; creatinine; bladder cancer; cancer mortality; distant metastasis; vinblastine; cancer invasion; gastrointestinal toxicity; surgeon; cystectomy; micrometastasis; glomerulus filtration rate; medical literature; therapy effect; robotics; drug dose regimen; neurologic disease; transitional cell carcinoma; muscle metastasis; creatinine clearance; multidisciplinary management; randomized controlled trial (topic); phase 3 clinical trial (topic); muscle invasive bladder cancer |
| Journal Title: | European Urology |
| Volume: | 59 |
| Issue: | 6 |
| ISSN: | 0302-2838 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2011-06-01 |
| Start Page: | 978 |
| End Page: | 984 |
| Language: | English |
| DOI: | 10.1016/j.eururo.2011.01.014 |
| PROVIDER: | scopus |
| PMCID: | PMC3137649 |
| PUBMED: | 21257257 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 23 June 2011" - "CODEN: EUURA" - "Source: Scopus" |
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