Current Value of Neoadjuvant Chemotherapy Prior to Cystectomy

摘要: Abstract Context Radical cystectomy with a pelvic lymph node dissection is considered the most effective treatment option today for patients muscle-invasive bladder cancer. Unfortunately, in spite of some progress, disease-specific survival rates after have not dramatically changed last few decades. The significant risk distant failure indicates that additional systemic mandatory. Objective primary objective review was to summarize data about benefit neoadjuvant chemotherapy before Evidence acquisition papers evaluating cohorts were analyzed including thorough analysis failures. presenting prospective randomized trials and meta-analyses on cancer critically reviewed. synthesis rationale treat micrometastases beyond margins local therapy already present at time diagnosis invasive Results indicate platinum-based combination chemotherapy. To improve interpretation from trials, several conducted. recent meta-analysis, published 2005, evaluated individual 3005 enrolled 11 controlled compared plus alone. comprised 98% all known eligible trials. found associated It equivalent 5% absolute improvement overall ( p =0.003) 9% disease-free Conclusions remains standard quality surgery essential optimal results. provide support preoperative application patients.