[Adjuvant polychemotherapy after radical cystectomy of metastatic bladder cancer]

The aim of adjuvant polychemotherapy after radical cystectomy for patients with a high risk of tumor progression is to improve cure rates or at least prolong survival. So far, three prospectively randomized and several retrospective studies analyzing the benefit of adjuvant polychemotherapy have been performed. All have revealed longer survival times after adjuvant chemotherapy. The up-dated data from our own study increasingly suggest that a significant improvement of tumor-free survival rates is also possible, which is in accordance with the retrospective studies published so far. The extension of lymph node involvement, however, seems to be the most important independent prognostic variable. Further studies are necessary to define therapy-specific risk groups and the potential therapeutic benefit in the different groups. The optimal chemotherapy combination and the optimal dosage also remain to be defined.