Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer

*Kari T. Syvänen,1 Hannu Järveläinen,2 Pekka Taimen,3 Matti Laato,4 Peter J. Boström5

1. Department of Urology, Turku University Hospital, Turku, Finland
2. Acting Professor, Department of Medical Biochemistry and Genetics, University of Turku, and
Division of Medicine, Department of Endocrinology, Turku University Hospital, Turku, Finland
3. Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
4. Professor, University of Turku and Department of Urology, Turku University Hospital, Turku, Finland
5. Associate Professor, University of Turku and Department of Urology, Turku University Hospital, Turku, Finland
*Correspondence to kari.syvanen@tyks.fi

Disclosure: No potential conflict of interest.
Received: 29.01.14 Accepted: 06.03.14
Citation: EMJ Urol. 2014;1:111-117.

Abstract

Neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer was introduced several years ago. Despite the evidence supporting its use in clinical practice, only a minority of patients who undergo radical cystectomy receive preoperative chemotherapy. In addition, recommendations and methods to detect patients who would benefit the most from NAC are still unclear. The European Association of Urology (EAU) guidelines panel on muscle-invasive and metastatic bladder cancer recommends the use of cisplatin-based NAC for T2-T4a, cN0 M0 bladder cancer if the patient has a performance status ≥2
and if the renal function is not impaired, but the American Urological Association, for example, does not have any guideline recommendations on this topic at all. In this review we describe the current literature supporting NAC in association with radical cystectomy in muscle-invasive urothelial carcinoma of the bladder. Evidence acquisition was made searching the Medline database for original articles published before 1st February 2014, with search terms: “neoadjuvant chemotherapy”, “radical cystectomy”, and “invasive bladder cancer”.

 

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