Radical cystectomy for invasive bladder cancer: contemporary results and remaining controversies

The impact of stage progression of superficial cancer to invasive disease is profound. However, the optimal-timed management of invasive bladder cancer is still controversial. Pelvic lymph node dissection and radical cystectomy are considered to be the optimal therapy regarding local tumor control and ultimate cure of cancer, whereas chemotherapy offers the only viable but limited option for patients with distant metastasis or locally advanced disease. Identification of conventional and molecular prognostic factors to predict cancer-specific survival following radical cystectomy is one important step to identify candidates that may benefit from early cystectomy or adjunct chemotherapy. With this background, the results of historic and contemporary radical cystectomy series for carcinoma of the bladder are reviewed.