[Recent controversy in treatment for advanced bladder cancer]

We summarized here the current status and controversy surrounding treatment for advanced bladder cancer, which may be defined as deeply invasive bladder cancer or invasive bladder cancer with distant metastasis. The definitive treatment for advanced bladder cancer is considered to be systemic chemotherapy. However, favorable results are not always obtained from CDDP-based combination chemotherapy alone. Therefore, the development of a dose-intensified regimen using G-CSF, intra-arterial chemotherapy, based on the concept of the drug delivery system, and combination therapy of radiation and chemotherapy, produced better results. Surgical treatment, a part of a multidisciplinary approach, may result in a complete response followed by a good prognosis.