[Neoadjuvant chemotherapy of locally advanced tumors of the bladder: introduction]

The locally advanced bladder cancer cannot be cured only with cystectomy: in this case the surgery has a palliative meaning and do not relieve the patient from the disease. Adjuvant or neoadjuvant treatments have been proposed to transform a palliative treatment in a curative method. Mainly radiotherapy and chemotherapy have been performed to achieve this goal. In fact radiotherapy failed to cure the locally advanced bladder cancer but in increasing survival in T3 cystectomized patients. So far chemotherapy with MP and M-VAC regimens demonstrated a good efficacy in achieving an early response rate in advanced diseases. In many urological centers chemotherapy has been carried out before cystectomy in order to have a pathological control of the response when cystectomy had been performed, and to verify an hypothetical increase in survival rates. The experiences among a group of urologists in Lombardy are reported in this issue. The preliminary results and the problems arisen in treating such patients and in following up both the cured and the relapsing patients are reported in short papers. The clinical problems are further discussed in the final panel discussion.