Multimodal therapies for muscle-invasive urothelial carcinoma of the bladder

作者：Keegan Kirk A; Resnick Matthew J; Clark Peter E^*

来源：Current Opinion in Oncology, 2012, 24(3): 278-283.

DOI：10.1097/CCO.0b013e3283510587

• bladder cancer
• chemotherapy
• multimodal therapy
• radiation
• review

Purpose of review
To evaluate the current literature for processes of care and outcomes of multimodal therapies for muscle-invasive urothelial carcinoma of the bladder.
Recent findings
Treatments for high-risk bladder cancer remain an active area of investigation. Despite evidence of the benefits, the use of chemotherapy, either neoadjuvant or adjuvant, remains underutilized. Given patient preference or baseline comorbidities, multimodal bladder-preserving strategies have been employed by several institutions, with rates of overall survival similar to radical cystectomy series. Late complications associated with these treatments were recently described. Future management strategies for solid tumors will incorporate a personalized approach based upon molecular diagnostic tools to predict risk of recurrence, progression, and response to specific therapeutic agents.
Summary
Multimodal paradigms for muscle-invasive urothelial carcinoma have demonstrated favorable clinical outcomes relative to radical cystectomy alone. Further work through properly conducted randomized trials and accurate individual-level risk assessments will facilitate the determination of the optimal candidates and timing for these treatments.

• 出版日期2012-5