Advances in the management of muscle-invasive bladder cancer through risk prediction, risk communication, and novel treatment approaches

Clin Adv Hematol Oncol. 2013 Feb;11(2):86-92.


Although level I evidence supports the use of neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy for the management of patients with muscle-invasive bladder cancer (MIBC), these treatment modalities are utilized in only a subset of patients. The reasons for lack of implementation of these treatment standards are multiple; patients may be considered ineligible for cisplatin or too old for safe cystectomy. Better means of determining a patient's probability of recurrence with surgery alone, or likelihood of benefit with neoadjuvant chemotherapy, are clearly needed. Models have been developed to individualize estimates of non-organ-confined disease based on pretreatment variables. It is critical that clinicians are able to effectively communicate complex risk-related data to patients to facilitate a shared medical decision.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Chemotherapy, Adjuvant / methods*
  • Cisplatin / therapeutic use
  • Cystectomy*
  • Disease Management
  • Humans
  • Muscle Neoplasms / pathology
  • Muscle Neoplasms / surgery
  • Muscle Neoplasms / therapy*
  • Neoadjuvant Therapy / methods*
  • Neoplasm Invasiveness
  • Precision Medicine
  • Risk
  • Urinary Bladder / drug effects
  • Urinary Bladder / pathology
  • Urinary Bladder / surgery
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery
  • Urinary Bladder Neoplasms / therapy*


  • Antineoplastic Agents
  • Cisplatin