Updated: April 2008
Prior to the development of effective chemotherapy, the median survival with metastatic bladder cancer was three to six months. Combination chemotherapy has improved median survival to about 12 months. However, long-term survival remains rare.
Platinum-based combination chemotherapy (Gemcitabine with either Cisplatin or Carboplatin) may be recommended as initial treatment for patients with advanced invasive urothelial carcinoma with an ECOG performance status of 0-2 (refer to GUAVPG).(23) Patients responding well to systemic therapy should be considered for regional treatment on an individualized basis. Patients should be encouraged to take part in clinical trials whenever possible.
Palliative radiotherapy continues to be an effective modality for relief of symptoms from local and distant sites of disease.