SYSTEMIC CHEMOTHERAPY FOR ADVANCED BLADDER-CARCINOMA

The influence of systemic chemotherapy on advanced bladder carcinoma i s limited. Apparently patients do not benefit from cytostatic treatmen t prior to surgical removal of the bladder (neoadjuvant chemotherapy). Combination chemotherapy subsequent to radical cystectomy is currentl y being investigated in several clinical trials, at present, however, adjuvant chemotherapy cannot be regarded as standard treatment. In met astatic disease responses following application of cisplatin and metho trexate were observed in approximately 50% of the patients without sig nificantly influencing cure. Regarding the progress in surgical techni ques including continent urinary diversion, improvement of chemotherap y through basic research and development of new cytotoxic agents and n ovel combination regimens is mandatory.