Neoadjuvant chemotherapy for bladder cancer: the pros and cons

Abstract

In the past 15 years, the results of studies on neoadjuvant chemotherapy have been contradictory. The 2005 meta-analysis pooled data on 3005 patients with bladder cancer. The results of the analysis show an absolute increase in survival by 5% over 5 years when neoadjuvant chemotherapy was used in combination with cisplatin in patients with T2-T4aN0 bladder cancer. These data are of clinical significance for patients with Stage 0-1 bladder cancer and creatinine clearance >50 ml/min and in those aged under 70 years.

With neoadjuvant chemotherapy used in combination with transurethral resection and radiation teletherapy, 5-survival rates are about 50%. Neoadjuvant chemotherapy with platinum agents should be used in multimodality treatment for invasive bladder cancer.