Abstract
Radical cystectomy is the standard treatment for patients with muscle-invasive bladder cancer. Bladder cancer is a chemoresponsive disease and should be dealt with in a multimodality approach. Neoadjuvant chemotherapy is intended for patients with operable clinical stage T2 to T4a muscle-invasive disease to improve survival. Meta-analysis of cisplatin-containing combination neoadjuvant chemotherapy trials revealed a 5% difference in favor of neoadjuvant chemotherapy. Bladder preservation in selected patients on the basis of response to neoadjuvant chemotherapy is a feasible approach. The goal now must be to find more effective drugs and to better predict the individual response to therapy.
MeSH terms
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Cisplatin / administration & dosage
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Cyclophosphamide / administration & dosage
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Cystectomy*
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Disease-Free Survival
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Doxorubicin / administration & dosage
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Drug Administration Schedule
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Humans
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Methotrexate / administration & dosage
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Neoadjuvant Therapy
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Proportional Hazards Models
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Survival Rate
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Urinary Bladder Neoplasms / drug therapy*
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Urinary Bladder Neoplasms / mortality
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Urinary Bladder Neoplasms / surgery*
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Vinblastine / administration & dosage
Substances
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Vinblastine
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Doxorubicin
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Cyclophosphamide
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Cisplatin
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Methotrexate
Supplementary concepts
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CISCA protocol
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M-VAC protocol
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MEC protocol 1