A total of 24 patients with urothelial cancer were treated with a combination chemotherapy consisting of vincristine (1 mg, i.v., day 1), bleomycin (15 mg, or peplomycin, 10 mg, i.m. day 2), mitomycin-C (4 mg, i.v. day 3), tegafur (600-750 mg, p.o., every day) and OK-432 (2-4 KE, i.m., day 1, 3, 5). This one-week course was repeated for an average of 4.6 courses. Of these cases, 13 patients with early stage treated as adjuvant chemotherapy after radical operation showed strong suppressive effects against tumor recurrence or metastasis except 3 cases. However, in advanced cancer this regimen was less effective. Therefore, we modified this regimen: VCR 2mg and PEP, 10 mg on days 2, 4 and 6. This modified regimen was given to two patients and one showed partial response and I-A according to Karnofsky's criteria. Mild side effects such as slight leukopenia, fever up, gastrointestinal symptoms or alopecia were observed. These results suggest that this regimen could be used as an adjuvant chemotherapy after radical operation of urothelial malignancy for the purpose of protecting tumor recurrence or metastasis.