In North America, bladder cancer is the fourth common cancer in men and seventh in women; over 90% are transitional cell carcinomas that arise throughout the urothelium, from the renal pelvis, urethra and most frequently the bladder itself. In the USA, after a rise in incidence rates from l970 to l980, age-adjusted death rates from this form of cancer have gradually been declining by 25% in the last decade. Nevertheless, half of all patients with muscle-invasive bladder cancer still die from their disease and routine local management ? total cystectomy or radical radiation therapy ? is not satisfactory; the following reviews the benefits of systemic chemotherapy as adjunct.
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