Abstract
Bladder cancer, most often of the transitional cell type (TCC), is the fourth most commonly diagnosed malignancy in the United States (1). About 75% of patients are diagnosed with localized disease at initial presentation, with about 20% having loco-regionally advanced (stage II/III) disease (2). Following radical cystectomy or definitive radiation therapy, recurrence risk in these patients exceeds 50% (3). Table 22.1 summarizes the data of the recent outcome for patients with locally advanced bladder cancer treated with cystectomy alone.
The high incidence of distant recurrence in patients with presumed early stage disease is principally due to the presence of distant micrometastases at the time of local therapy. Because of this, recent research has revolved around peri-operative systemic therapy, either as neoadjuvant or adjuvant treatment, aimed at eradicating micrometastatic deposits. Alternative (non-cystectomy) approaches for localized disease have also been investigated, particularly radiation therapy with or without chemotherapy. This review summarizes current data on therapeutic strategies for locally advanced bladder cancer.
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Chee, K.G., Lara, P.N. (2009). Neoadjuvant Chemotherapy: The New Standard. In: Lee, C., Wood, D. (eds) Bladder Cancer. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-59745-417-9_22
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