CurrentView of Metastatic Cell Carcinoma of Urinary Bladder from the Standpoint of Survival in Relation to the Mode ofTherapy

Overview

Metastatic transitional cell carcinoma of the bladder is an aggressive neoplasm characterizedby rapid growth and dissemination with median survival of typically less than 1 year. Despitethe availability of a myriad of antineoplastics with moderate-significant anti-tumor activityyielding overall response rates in the 40 % to 80 % range, randomized trials continue todemonstrate median survival rates in the 13- to 14-month range, with very limited long-termsurvival. Subsets of patients with advanced bladder cancer present additional managementproblems, including those with renal insufficiency or nontransitional-cell histology. The optimalchemotherapy combination for patients with advanced bladder cancer remains undefined,however, there is increasing recognition that in order to achieve tangible improvements incomplete response rates and survival in this disease will likely require a combination ofchemotherapy and targeted molecular therapies and in some setting adjunctive surgery.

Key words:
cell carcinoma of the bladder - chemotherapy - surgery.