Stenzl - Figure 21
Neoadjuvant chemotherapy
FIG. 21: We know that despite a sharp rise in neoadjuvant chemotherapy (dark blue line, Figure), based on results from Grossman and others[14] and meta-analyses published years ago,[15,16] these patients have a better outcome both in progression and survival or recurrence and survival after definitive cystectomy.[17] However cystectomy is still not applied in the majority of cases. There may be clinical reasons for this, but there is also uncertainty, and what we definitively need to know is whether we can really identify those patients who will not benefit from neoadjuvant chemotherapy, despite its advantages with regard to survival in some.
References
Grossman HB, Natale RB, Tangen CM, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 2003;349:859−66
Advanced Bladder Cancer (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;48:202−5
Leow JJ, Martin-Doyle W, Rajagopal PS, et al. Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials. Eur Urol. 2014;66:42−54
Hermans TJ, Fransen van de Putte EE, Horenblas S, et al. Perioperative treatment and radical cystectomy for bladder cancer--a population based trend analysis of 10,338 patients in the Netherlands. Eur J Cancer. 2016;54:18−26 http://dx.doi.org/10.1016/j.ejca.2015.11.006
