Perioperative therapies for urological cancers

Area of Science:

• Oncology
• Urology

Background:

• Surgery is crucial for localized cancers, but multimodal therapies like neoadjuvant and adjuvant treatments aim to improve outcomes.
• Evidence supporting multimodal therapy in urological cancers is often limited or controversial.
• Recent advancements include immune checkpoint inhibitors, increasing clinical trial activity.

Purpose of the Study:

• To review the current evidence for perioperative therapies in urological cancers.
• To summarize the status of neoadjuvant and adjuvant treatments for prostate, urothelial, and renal cell carcinoma.

Main Methods:

• Literature review of randomized controlled trials and recent studies.
• Focus on neoadjuvant and adjuvant therapies, including chemotherapy and immune checkpoint inhibitors.
• Analysis of evidence for bladder cancer, prostate cancer, urothelial cancer, and renal cell carcinoma.

Main Results:

• Neoadjuvant cisplatin-based chemotherapy benefits muscle-invasive bladder cancer.
• Perioperative therapy for other urological cancers remains controversial with limited definitive conclusions.
• Emerging data on immune checkpoint inhibitors in perioperative settings are rapidly accumulating.

Conclusions:

• Neoadjuvant chemotherapy is established for muscle-invasive bladder cancer.
• Further research is needed to establish the role of perioperative therapies in other urological malignancies.
• Immune checkpoint inhibitors represent a promising area for future perioperative treatment strategies.