Let's talk about neoadjuvant or adjuvant therapy for muscle-invasive bladder cancer.
We know that patients with PT three, PT four, and N-positive disease have low survival rates five years after cystectomy. Recurrence is primarily due to systemic metastatic disease at the time of diagnosis.
We know that cisplatin-based combination chemotherapy is effective in metastatic disease. Survival is shown to be prolonged as neoadjuvant treatment. And in most cases.