Abstract
Chemotherapy for advanced bladder cancer: 'Midsummer Night's Dream' or 'Much Ado About Nothing'?
Highlights
The past decade has seen important progress in our understanding of the biology and management of bladder cancer, one of the most common malignancies in Western society
It has become increasingly clear that, despite the best available treatment, approximately 50 per cent of patients presenting with invasive transitional cell carcinoma will die within 5 years (Skinner & Lieskovsky, 1984; Gospodarowicz et al, 1989)
Since 1977, many uncontrolled trials have yielded high objective response rates and a broad range of toxicity when combination chemotherapy regimens have been applied to this problem
Summary
Chemotherapy for advanced bladder cancer: 'Midsummer Night's Dream' or 'Much Ado About Nothing'?. It has become increasingly clear that, despite the best available treatment, approximately 50 per cent of patients presenting with invasive transitional cell carcinoma will die within 5 years (Skinner & Lieskovsky, 1984; Gospodarowicz et al, 1989). The traditional determinants of adverse prognosis include advanced tumour stage, size, high grade, and the presence of hydronephrosis (Shipley et al, 1984; Gospodarowicz et al, 1989), and studies are in progress to determine the relative utility of these factors, compared to the more recently introduced determinants listed above. Patients with invasive, but clinically non-metastatic bladder cancer have more recently been treated with initial systemic chemotherapy as part of planned definitive treatment in an attempt to improve cure rates. It is timely to discuss the available data regarding the use of chemotherapy for locally advanced, recurrent and metastatic bladder cancer
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