Adjuvant chemotherapy (AC) for muscle-invasive bladder cancer: A pooled analysis from phase III studies

4664 Background: Better treatment of muscle-invasive bladder cancer requires the eradication of local disease and the elimination of potential micrometastases. Yet, radical cystectomy remains the gold standard treatment for muscle invasive bladder cancer, since the role of peri-operative chemotherapy is still unclear. Although a meta-analysis (Vale, Lancet 2003) of neoadjuvant chemotherapy has shown a significant increase in overall survival (5% absolute benefit at 5-years), its clinical impact is limited because a number of patients is overtreated and the bladder is lost. AC has the advantage of being administered to patients with proper pathologic staging and known prognostic factors of relaspse risk. Few studies with limited samples and statistic power however have been published, thus providing insufficient evidence to support the routine use of post-cystectomy AC (Sylvester, Ann Oncol 2000). The aim of this pooled analysis is to verify if AC is able to increase the disease-free survival and then the ...