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Urological Oncology pp 591–608Cite as

Invasive Bladder Cancer: Combined Modality Treatment

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Abstract

Invasive bladder cancer is associated with a cure rate of only 50 %, when all stages are considered. The pattern of relapse is dominated by systemic spread, with metastases occurring despite local control. In the past three decades, new approaches to treatment have been predicated on the use of systemic chemotherapy before, during or after loco-regional management in an attempt to control occult systemic disease. In parallel, more aggressive surgical approaches and modified radiation techniques in association with systemic chemotherapy have been employed to secure improved local control. More recently, molecular prediction has been applied to this clinical problem, with gene expression being studied as a prognostic and predictive marker. Of particular importance, P53 mutation and expression of the epidermal growth factor receptor may predict for natural history and/or response to treatment. Novel therapies are being tested in the neoadjuvant and adjuvant setting.

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Author information

Authors and Affiliations

  1. Levine Cancer Institute, Carolinas HealthCare System, 32861, Charlotte, NC, 28232, USA

    Derek Raghavan MD, PhD, FRACP, FACP, FASCO

  2. Department of Radiation Oncology, Cedars Sinai Cancer Center, Los Angeles, CA, USA

    Howard M. Sandler MD, MS, FASTRO

Authors
  1. Derek Raghavan MD, PhD, FRACP, FACP, FASCO
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  2. Howard M. Sandler MD, MS, FASTRO
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Corresponding author

Correspondence to Derek Raghavan MD, PhD, FRACP, FACP, FASCO .

Editor information

Editors and Affiliations

  1. Department of Urology, Homerton University Hospital & Formerly St. Bartholomew's Hospital, London, United Kingdom

    Vinod H. Nargund

  2. Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina, USA

    Derek Raghavan

  3. Radiation Oncology, Cedars Sinai Cancer Center, Los Angeles, California, USA

    Howard M. Sandler

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Raghavan, D., Sandler, H.M. (2015). Invasive Bladder Cancer: Combined Modality Treatment. In: Nargund, V., Raghavan, D., Sandler, H. (eds) Urological Oncology. Springer, London. https://doi.org/10.1007/978-0-85729-482-1_34

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