[Cancers of the bladder: new therapeutic orientations]

Based on data obtained from a general review of treatment of infiltrating cancer of bladder, new therapeutic orientations are proposed in which chemotherapy occupies a privileged position as adjuvant treatment of surgical excision. Emphasis is placed on the frequency of bladder cancer and invasive tumors, as well as the high incidence of unsuccessful results due not to local recurrence but to metastases that do not respond to local and regional radiosurgical treatment. Objective results are obtained in approximately 50% of measurable metastases after combined Adriamycin and Cisplatin treatment. The efficacy of this chemotherapy suggests its prophylactic use to eradicate microscopic metastatic lesions remaining after local and regional therapy. If indications are well chosen, and not too heavy chemotherapy administered, then it is probable that as complementary treatment to surgical excision should improve efficacy of treatment of infiltrating cancer of bladder. The observation of necrosis of pulmonary metastases during chemotherapy provides justification for therapeutic orientation of this type.