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Clin Adv Hematol Oncol. 2013 Feb;11(2):86-92.

Advances in the management of muscle-invasive bladder cancer through risk prediction, risk communication, and novel treatment approaches.

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Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York 10029, USA.


Although level I evidence supports the use of neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy for the management of patients with muscle-invasive bladder cancer (MIBC), these treatment modalities are utilized in only a subset of patients. The reasons for lack of implementation of these treatment standards are multiple; patients may be considered ineligible for cisplatin or too old for safe cystectomy. Better means of determining a patient's probability of recurrence with surgery alone, or likelihood of benefit with neoadjuvant chemotherapy, are clearly needed. Models have been developed to individualize estimates of non-organ-confined disease based on pretreatment variables. It is critical that clinicians are able to effectively communicate complex risk-related data to patients to facilitate a shared medical decision.

[Indexed for MEDLINE]

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