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Oncology (Williston Park). 2007 Dec;21(14):1673-81; discussion 1686-8, 1691, 1694.

Neoadjuvant chemotherapy for bladder cancer.

Author information

1
Department of Medicine, Section of Medical Oncology, Baylor College of Medicine, Webster 77598, USA. guru.sonpavde@usoncology.com

Abstract

Occult distant micrometastasis at the time of radical cystectomy leads predominantly to distant failures in patients with locally advanced muscle-invasive transitional cell carcinoma of the bladder. Cisplatin-based combination chemotherapy enhances survival in patients with metastatic urothelial cancer. Studies evaluating adjuvant chemotherapy have been limited by inadequate statistical power. However, randomized clinical trials have demonstrated a survival benefit for neoadjvuant cisplatin-based combination chemotherapy, which should be considered a standard of care. In addition, neoadjuvant therapy may assist in the rapid development of novel systemic therapy regimens, since pathologic complete remission appears to be a powerful prognostic factor for long-term outcomes. Patients who are either unfit for or refuse radical cystectomy may benefit from neoadjuvant chemotherapy with or without radiation to enable bladder preservation.

PMID:
18247016
[Indexed for MEDLINE]
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