Contemporary management of muscle-invasive bladder cancer

Over the past decade, there have been a number of substantial changes in the treatment of invasive bladder cancer. Muscle-invasive bladder cancer is an aggressive disease that often presents at an advanced stage with or without distant metastases. The potential for cure is highest when the disease is confined to the bladder. Optimal management depends on our understanding of disease biology, refinements to our clinical staging, and improvements in the quality of treatment. This review will focus on the contemporary management of muscle-invasive urothelial carcinoma of the bladder and will discuss the role of radical cystectomy, extended lymphadenectomy, neoadjuvant/ adjuvant chemotherapy, and various forms of bladder-preservation strategies.