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Neoadjuvant or adjuvant chemotherapy: what is the best treatment of muscle invasive bladder cancer?

Nabil Ismaili, Sanaa Elmajjaoui, Youssef Bensouda, Rhizlane Belbaraka, Halima Abahssain, Wafa Allam, Zouhour Fadoukhair, Mohamed Mesmoudi, Rachid Tanz, Tarik Mahfoud, Abdelhamid Elomrani, Mouna Khouchani, Yassir Sbitti, Noureddine Benjaafar, Hassan Errihani, Ali Tahri
  • Sanaa Elmajjaoui
    Institut National d’Oncologie, Rabat, Morocco
  • Youssef Bensouda
    Institut National d’Oncologie, Rabat, Morocco
  • Rhizlane Belbaraka
    Centre d’oncologie, CHU Mohamed VI, Marrakech, Morocco
  • Halima Abahssain
    Institut National d’Oncologie, Rabat, Morocco
  • Wafa Allam
    Institut National d’Oncologie, Rabat, Morocco
  • Zouhour Fadoukhair
    Institut National d’Oncologie, Rabat, Morocco
  • Mohamed Mesmoudi
    Institut National d’Oncologie, Rabat, Morocco
  • Rachid Tanz
    Institut National d’Oncologie, Rabat, Morocco
  • Tarik Mahfoud
    Institut National d’Oncologie, Rabat, Morocco
  • Abdelhamid Elomrani
    Centre d’oncologie, CHU Mohamed VI, Marrakech, Morocco
  • Mouna Khouchani
    Centre d’oncologie, CHU Mohamed VI, Marrakech, Morocco
  • Yassir Sbitti
    Institut National d’Oncologie, Rabat, Morocco
  • Noureddine Benjaafar
    Institut National d’Oncologie, Rabat, Morocco
  • Hassan Errihani
    Institut National d’Oncologie, Rabat, Morocco
  • Ali Tahri
    Centre d’oncologie, CHU Mohamed VI, Marrakech, Morocco

Abstract

Bladder cancer is the fourth most common cancer for men and the eighth most common cancer for women. Transitional cell carcinoma is the most predominant histological type. Bladder cancer is highly chemosensitive. In metastatic setting the treatment is based on cisplatin chemotherapy regimens type MVAC, MVAC-HD or gemcitabine plus cisplatin. The standard treatment of muscle invasive operable bladder cancer (T2–T4) used widely was radical cystectomy with pelvic lymph nodes dissection; the anatomical extent of pelvic lymphadenectomy has not accurately been defined so far. However, in the last decade, the treatment of tumors was improved by the introduction of chemotherapy as part of the management of the disease. Neoadjuvant chemotherapy should be considered at first, as standard treatment of choice, before local treatment for patients with good performance status (0–1) and good renal function–glomerular filtration rate (GFR) >60 mL/min. For patients treated with primary surgery, adjuvant chemotherapy is a valuable option in the case of lymph nodes involvement. This brief review would provide the evidence of the role of neoadjuvant chemotherapy in the management of operable muscle invasive (T2–T4) bladder cancer.

Keywords

Bladder cancer – Chemotherapy – Neoadjuvant chemotherapy – Adjuvant chemotherapy

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Submitted: 2011-12-02 10:12:59
Published: 2011-09-30 00:00:00
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Copyright (c) 2011 Nabil Ismaili, Sanaa Elmajjaoui, Youssef Bensouda, Rhizlane Belbaraka, Halima Abahssain, Wafa Allam, Zouhour Fadoukhair, Mohamed Mesmoudi, Rachid Tanz, Tarik Mahfoud, Abdelhamid Elomrani, Mouna Khouchani, Yassir Sbitti, Noureddine Benjaafar, Hassan Errihani, Ali Tahri

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