@article{53352bf2b3e348fdbcfc35e849509d3a,
title = "Managing locally advanced bladder cancer",
abstract = "Locally advanced bladder cancer comprising tumor stages pT3a, pT3b, pT4a of the 1997 TNM system and/or involvement of regional lymphnodes can be cured by radical cystectomy. However, at least 50% of patients experience systemic progression within 5 years after surgery. In order to improve the fate of these patients, the administration of additional therapy has been studied in various forms, such as neoadjuvant and adjuvant systemic chemotherapy, as well as combined radiochemotherapy. Results from more than a dozen randomized Phase III trials on adjunctive chemotherapy, which include cystectomy as definite treatment have been reported. Whether neoadjuvant or adjuvant systemic chemotherapy is the superior form of adjunctive therapy for locally advanced bladder cancer continues to be a matter of dispute.",
keywords = "Chemotherapy, Gemcitabine, Locally advanced bladder cancer, MVAC/MVEC, Radiochemotherapy, Systemic, Transitional cell carcinoma, Urothelial cancer",
author = "Jan Lehmann and Margitta Retz and Stefan Siemer and J{\"o}rn Kamradt and Bernd Wullich and Michael St{\"o}ckle",
note = "Funding Information: Secondly, the largest trial to date of neoadjuvant chemotherapy for muscle-invasive bladder cancer sponsored by the European Organisation for the Research and Treatment of Cancer (EORTC) and Medical Research Council (MRC) included 976 patients (Stages T2G3, T3, T4a, N0-NX, M0) from 106 centers in 20 countries. Patients were randomly scheduled to three cycles of cisplatin, methotrexate, vinblastine (CMV) prior to definite therapy (n = 491) or no neoadjuvant therapy (n = 485). Definite therapy was performed as radical cystectomy or radiation therapy left to the discretion of the participating investigators. At the time of the first publication, no significant survival difference was found comparing the overall survival rate at 3 years (55.5% for neoadjuvant chemotherapy vs. 50.0% for definite treatment only, p = 0.075) [16]. However, very recently, a significant difference was reported for the 5-year overall survival rates (56.0% neoadjuvant chemotherapy versus 50.0% for definite treatment only, p = 0.048) [13].",
year = "2002",
month = dec,
doi = "10.1586/14737140.2.6.656",
language = "English",
volume = "2",
pages = "656--666",
journal = "Expert Review of Anticancer Therapy",
issn = "1473-7140",
publisher = "Taylor and Francis Ltd.",
number = "6",
}
