From Sept. 83 to Sept. 86, 20 patients (pts), mean age 65 yr, with a muscle-infiltrating bladder tumor would normally have been treated by total cystectomy. Pts were staged by intravenous urography, pelvic and abdominal CT, physical examination under general anesthesia, and deep TUR, then given neoadjuvant chemotherapy: cisplatinum and 5-FU. Courses were given every 28 days. Results were evaluated after the 3rd and 6th courses by CT, IVP and TUR. 9 pts had a histologically confirmed complete clinical response (pCR: 6 pT2, 2 pT3, 1 pT4). Median follow-up in Jan. 1988 was 30 mo. (17-52). This protocol was objectively active and well tolerated, even by elderly pts. Problems remain concerning pCR pts: (1) the respective roles of chemotherapy and TUR on the outcome; (2) prevention of recurrence (5/9 pCR).