Neo-adjuvant and adjuvant chemotherapy in bladder cancer.

Transitional cell carcinoma of the bladder represents the second most common genitourinary malignancy [1]; the clinical approach to muscle-invasive disease has been modified in the last decade, considering the important role of multidisciplinary team, including surgeon, oncologist and radiotherapist. In fact, despite relevant progress in surgical management of these patients, the global prognosis remains poor, with about 50% of patients developing metastatic disease. Moving from these issues, in the two last decades, a big effort has been made in order to evaluate an ameliorating strategy for muscle-invasive bladder cancer [2]. In metastatic setting, chemotherapy obtains about 50% of objective response, with a median progression-free survival of about 8 months and a median overall survival of about 14 months [3, 4]. Given the chemosensitivity of transitional cell carcinoma, chemotherapy has been investigated in preoperative setting.