Value of current chemotherapy and surgery in advanced and metastatic bladder cancer.

Abstract:

:The aim of the present paper was to review findings from the most relevant studies and to evaluate the value of current chemotherapy and surgery in advanced unresectable and metastatic bladder cancer. Studies were identified by searching the MEDLINE® and PubMed® databases up to 2011 using both medical subject heading (Mesh) and a free text strategy with the name of the known individual chemotherapeutic drug and the following key words: 'muscle-invasive bladder cancer', 'chemotherapeutics agents', and 'surgery in advanced bladder cancer'. At the end of our literature research we selected 141 articles complying with the aim of the review. The results showed that it has been many years since the MVAC (methotrexate, vinblastine, adriamycin, cisplatin) regimen was first developed. The use of cisplatin-based combination chemotherapy is associated with significant toxicity and produces long-term survival in only approximately 15-20% of patients. Gemcitabine + cisplatin represents the gold standard in the treatment of metastatic bladder cancer. In conclusion, the optimal approach in the management of advanced urothelial cancer continues to evolve. Further progress relies on the expansion of research into tumor biology and an understanding of the underlying molecular 'fingerprints' that can be used to enhance diagnostic and therapeutic strategies. Cisplatin-based therapy has had the best track record thus far.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Racioppi M,D'Agostino D,Totaro A,Pinto F,Sacco E,D'Addessi A,Marangi F,Palermo G,Bassi PF

doi

10.1159/000335556

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

249-58

issue

3

eissn

0042-1138

issn

1423-0399

pii

000335556

journal_volume

88

pub_type

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