Despite adequate surgical treatment by radical cystectomy and pelvic lymphadenectomy, about half of patients suffering from muscle-invasive urothelial bladder cancer will die. Both overall and cancer-specific survival has been improved by neoadjuvant chemotherapy. However, it is still not possible to predict who is likely to benefit from neoadjuvant treatment and who will not. In contrast to neoadjuvant chemotherapy, the efficacy of adjuvant chemotherapy has not definitely been proven. In metastatic urothelial cancer chemotherapy is usually a palliative treatment option. However, in a significant proportion of patients, disease stabilisation and even long-term response can be achieved. Important advances to tailor first- and second-line chemotherapy have recently been reported for clinical prognostic parameters. This review discusses the current standards and developments in the chemotherapeutic treatment of urothelial bladder cancer. Furthermore, it should provide a framework for reasonable treatment choices in daily clinical practice.

译文

:尽管通过彻底的膀胱切除术和盆腔淋巴结清扫术进行了适当的手术治疗,但约有一半患有肌肉浸润性膀胱尿路上皮癌的患者会死亡。新辅助化疗改善了总生存期和癌症特异性生存期。但是,仍无法预测谁可能从新辅助治疗中受益,而谁则不会。与新辅助化疗相反,辅助化疗的功效尚未得到肯定的证实。在转移性尿路上皮癌中,化疗通常是姑息治疗的选择。但是,在相当大比例的患者中,可以实现疾病稳定甚至长期反应。最近已经报道了调整一线和二线化疗的重要进展,可用于临床预后指标。这篇综述讨论了尿路上皮膀胱癌的化学治疗的当前标准和发展。此外,它应该为日常临床实践中合理的治疗选择提供一个框架。

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