Skip to main content
SpringerLink
Log in

Neoadjuvant Chemotherapy in Muscle Invasive Urothelial Bladder Cancer

  • Chapter
  • First Online:
Robotic Urology

  • 1198 Accesses

Abstract

Efficacy of cisplatin-based neoadjuvant chemotherapy (NC) regarding improvement of cancer-specific outcomes in patients suffering from urothelial bladder carcinoma (UBC) has been shown in randomized trials and confirmed within three large metaanalyses. Accordingly, recent guidelines on treatment of UBC patients recommend the use of NC. Most frequently, a combination therapy with gemcitabine and cisplatin is used, despite prospective data comparing this regimen to cisplatin-based combinations used in the historical randomized trials. The ideal patient to undergo NC before radical cystectomy presents with a good performance status and renal function. Though outcome differences depending on tumor stage have not been shown in the meta-analyses and pre-cystectomy staging is often inadequate, ≥T3 N0 patients are those most likely to benefit from NC.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Madersbacher S, et al. Radical cystectomy for bladder cancer today—a homogeneous series without neoadjuvant therapy. J Clin Oncol. 2003;21(4):690–6.

    Article  PubMed  Google Scholar 

  2. Hautmann RE, et al. Cystectomy for transitional cell carcinoma of the bladder: results of a surgery only series in the neobladder era. J Urol. 2006;176(2):486–92. discussion 491-2.

    Article  PubMed  Google Scholar 

  3. Hautmann RE, et al. Radical cystectomy for urothelial carcinoma of the bladder without neoadjuvant or adjuvant therapy: long-term results in 1100 patients. Eur Urol. 2012;61(5):1039–47.

    Article  PubMed  Google Scholar 

  4. Miles BJ, et al. Referral and treatment rates of neoadjuvant chemotherapy in muscle-invasive bladder cancer before and after publication of a clinical practice guideline. Can Urol Assoc J. 2010;4(4):263–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. David KA, et al. Low incidence of perioperative chemotherapy for stage III bladder cancer 1998 to 2003: a report from the National Cancer Data Base. J Urol. 2007;178(2):451–4.

    Article  PubMed  Google Scholar 

  6. Winquist E, et al. Neoadjuvant chemotherapy for transitional cell carcinoma of the bladder: a systematic review and meta-analysis. J Urol. 2004;171(2 Pt 1):561–9.

    Article  CAS  PubMed  Google Scholar 

  7. ABC-Meta-analysis-Collaboration. Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration. Eur Urol. 2005;48(2):202–5. discussion 205–6.

    Article  Google Scholar 

  8. ABC-Meta-analysis-Collaboration. Neoadjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis. Lancet. 2003;361(9373):1927–34.

    Article  CAS  Google Scholar 

  9. Sherif A, et al. Neoadjuvant cisplatin-methotrexate chemotherapy for invasive bladder cancer—Nordic cystectomy trial 2. Scand J Urol Nephrol. 2002;36(6):419–25.

    Article  CAS  PubMed  Google Scholar 

  10. Grossman HB, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med. 2003;349(9):859–66.

    Article  CAS  PubMed  Google Scholar 

  11. Malmstrom PU, et al. Five-year followup of a prospective trial of radical cystectomy and neoadjuvant chemotherapy: Nordic Cystectomy Trial I. The Nordic Cooperative Bladder Cancer Study Group. J Urol. 1996;155(6):1903–6.

    Article  CAS  PubMed  Google Scholar 

  12. Inernational-Collaboration-of-Trialists. Neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: a randomised controlled trial. International collaboration of trialists. Lancet. 1999;354(9178):533–40.

    Article  Google Scholar 

  13. International Collaboration of Trialists. International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. J Clin Oncol. 2011;29(16):2171–7.

    Article  PubMed Central  Google Scholar 

  14. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, D.K., AWMF). S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Harnblasenkarzinoms. Langversion 1.1. 2016 [cited 2017 February 2017]; http://leitlinienprogramm-onkologie.de/Harnblasenkarzinom.92.0.html.

  15. Milowsky MI, et al. Guideline on Muscle-Invasive and Metastatic Bladder Cancer (European Association of Urology Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement. J Clin Oncol. 2016;34(16):1945–52.

    Article  PubMed  Google Scholar 

  16. Alfred Witjes J, et al. Updated 2016 EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol. 2017;71(3):462–75.

    Article  CAS  PubMed  Google Scholar 

  17. National Institute for Health and Care Excellence (NICE). Bladder cancer: diagnosis and management. 2015 [cited2017 February 21]; https://www.nice.org.uk/guidance/NG2.

  18. Dash A, et al. A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer. 2008;113(9):2471–7.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Zargar H, et al. Multicenter assessment of neoadjuvant chemotherapy for muscle-invasive bladder cancer. Eur Urol. 2015;67(2):241–9.

    Article  PubMed  Google Scholar 

  20. Galsky MD, et al. Comparative effectiveness of gemcitabine plus cisplatin versus methotrexate, vinblastine, doxorubicin, plus cisplatin as neoadjuvant therapy for muscle-invasive bladder cancer. Cancer. 2015;121(15):2586–93.

    Article  CAS  PubMed  Google Scholar 

  21. Yin M, et al. Neoadjuvant chemotherapy for muscle-invasive bladder cancer: a systematic review and two-step meta-analysis. Oncologist. 2016;21(6):708–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Johnson DC, et al. Neoadjuvant chemotherapy for bladder cancer does not increase risk of perioperative morbidity. BJU Int. 2014;114(2):221–8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Anderson EH. The associate degree program—a step to the baccalaureate degree in nursing. NLN Publ 1972;(15–1473):40–4.

    Google Scholar 

  24. Al-Daghmin A, et al. Efficacy of robot-assisted radical cystectomy (RARC) in advanced bladder cancer: results from the International Radical Cystectomy Consortium (IRCC). BJU Int. 2014;114(1):98–103.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Johar RS, et al. Complications after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium. Eur Urol. 2013;64(1):52–7.

    Article  PubMed  Google Scholar 

  26. Dogliotti L, et al. Gemcitabine plus cisplatin versus gemcitabine plus carboplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium: results of a randomized phase 2 trial. Eur Urol. 2007;52(1):134–41.

    Article  CAS  PubMed  Google Scholar 

  27. Galsky MD, et al. Treatment of patients with metastatic urothelial cancer “unfit” for Cisplatin-based chemotherapy. J Clin Oncol. 2011;29(17):2432–8.

    Article  PubMed  Google Scholar 

  28. Hussain SA, et al. A study of split-dose cisplatin-based neo-adjuvant chemotherapy in muscle-invasive bladder cancer. Oncol Lett. 2012;3(4):855–9.

    PubMed  PubMed Central  CAS  Google Scholar 

  29. Canter D, et al. Baseline renal function status limits patient eligibility to receive perioperative chemotherapy for invasive bladder cancer and is minimally affected by radical cystectomy. Urology. 2011;77(1):160–5.

    Article  PubMed  Google Scholar 

  30. Niegisch G, et al. Neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer: which patients benefit? Eur Urol. 2013;64(3):355–7.

    Article  PubMed  Google Scholar 

  31. Koga F, et al. Favourable outcomes of patients with clinical stage T3N0M0 bladder cancer treated with induction low-dose chemo-radiotherapy plus partial or radical cystectomy vs immediate radical cystectomy: a single-institutional retrospective comparative study. BJU Int. 2009;104(2):189–94.

    Article  PubMed  Google Scholar 

  32. Svatek RS, et al. Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort. BJU Int. 2011;107(6):898–904.

    Article  PubMed  Google Scholar 

  33. Scosyrev E, et al. Do mixed histological features affect survival benefit from neoadjuvant platinum-based combination chemotherapy in patients with locally advanced bladder cancer? A secondary analysis of Southwest Oncology Group-Directed Intergroup Study (S8710). BJU Int. 2011;108(5):693–9.

    Article  CAS  PubMed  Google Scholar 

  34. Wasco MJ, et al. Urothelial carcinoma with divergent histologic differentiation (mixed histologic features) predicts the presence of locally advanced bladder cancer when detected at transurethral resection. Urology. 2007;70(1):69–74.

    Article  PubMed  Google Scholar 

  35. Cheng L, et al. Small cell carcinoma of the urinary bladder: a clinicopathologic analysis of 64 patients. Cancer. 2004;101(5):957–62.

    Article  PubMed  Google Scholar 

  36. Erdem GU, et al. Small cell carcinoma of the urinary bladder: changing trends in the current literature. Curr Med Res Opin. 2016;32(6):1013–21.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Duesseldorf, Germany

    Günter Niegisch & Peter Albers

Authors
  1. Günter Niegisch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Albers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Günter Niegisch .

Editor information

Editors and Affiliations

  1. Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland

    Hubert John

  2. Department of Urology, Karolinska Institutet, Stockholm, Sweden

    Peter Wiklund

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Niegisch, G., Albers, P. (2018). Neoadjuvant Chemotherapy in Muscle Invasive Urothelial Bladder Cancer. In: John, H., Wiklund, P. (eds) Robotic Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-65864-3_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65864-3_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65863-6

  • Online ISBN: 978-3-319-65864-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation