Grossman - Figure 4
Rationale for Neoadjuvant Chemotherapy
FIG. 4: The rationale for neoadjuvant chemotherapy is relatively straightforward. It has been well established that patients treated with radical cystectomy can develop metastases outside the pelvis. Furthermore, it is likely that these metastases represent subclinical disease undetected at the time of surgery. Even with our best imaging modalities – CT, MRI, and PET scans – there is a level of disease that cannot be detected and likely exists.
It has also been well established that multi-agent chemotherapy can cure some patients with metastatic bladder cancer. Therefore, it is not unrealistic to expect that treating patients with neoadjuvant chemotherapy will improve survival by obliterating occult metastases.
