Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 3;8(2):193-209.
doi: 10.3233/BLC-211529. eCollection 2022.

Efficacy of Surgery on the Primary Tumour in Patients with Metastatic Bladder Cancer: A Comprehensive Review

Amy H Lim  1 , Mary E Westerman  1 , Andrea Korokovic  1 , Justin T Matulay  1 , Vikram M Narayan  1 , Neema Navai  1
Affiliations

Efficacy of Surgery on the Primary Tumour in Patients with Metastatic Bladder Cancer: A Comprehensive Review

Amy H Lim et al. Bladder Cancer. .

Abstract

Background: The benefit of surgery of the primary tumor in metastatic bladder cancer is unknown.

Objective: Perform a comprehensive contemporary literature review on the benefit of surgery of the primary tumor in metastatic bladder cancer.

Methods: Ovid MEDLINE, Ovid EMBASE, and Cochrane Library from January 1, 1990 to April 20, 2020 were queried for relevant articles published in English. Each article was evaluated by at least two content experts prior to inclusion which were blinded to the other's evaluation. A third content expert was used when there was not a unanimous decision. Additional articles were added at the discretion of the authors.

Results: Long-term survival is possible in patients with initially unresectable and/or limited metastatic disease. Multi-modal therapy with chemotherapy and surgery have the most favorable outcomes when compared to single treatment modalities in selected populations. Patients who demonstrate a robust response to pre-surgical therapy are likely to benefit the most from consolidative surgery. Patients with distant metastatic disease may benefit from consolidative surgery; however, this benefit may only be seen in those with metastatic disease limited to one site.

Conclusions: Surgery of the primary tumor in metastatic bladder cancer either in the setting of surgery alone, consolidative therapy or coupled with adjuvant therapy may be beneficial in well selected patients and should generally be limited to those who have a response to primary chemotherapy. Randomized clinical control trials are needed to further our understanding of the role of surgery in metastatic bladder cancer.

PubMed Disclaimer

Conflict of interest statement

Amy H. Lim, MD, PhD: no conflict of interest to report Vikram M. Narayan, MD: no conflict of interest to report Justin T. Matulay, MD: no conflict of interest to report Andrea Korokovic, MD: no conflict of interest to report Mary E. Westerman, MD: no conflict of interest to report Neema Navai, MD: no conflict of interest to report

Figures

Fig. 1
Fig. 1
PRISMA Flow Diagram.
See this image and copyright information in PMC

References

    1. Ploeg M, Aben KK, Kiemeney LA The present and future burden of urinary bladder cancer in the world. World J Urol. 2009;27(3):289–93. - PMC - PubMed
    1. Network NCCN. Bladder Cancer (Version 6.2020). Available from: https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf.
    1. von der Maase H, Sengelov L, Roberts JT, Ricci S, Dogliotti L, Oliver T, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol. 2005;23(21):4602–8. - PubMed
    1. Kitamura H, Tsukamoto T, Shibata T, Masumori N, Fujimoto H, Hirao Y, et al. Randomised phase III study of neoadjuvant chemotherapy with methotrexate, doxorubicin, vinblastine and cisplatin followed by radical cystectomy compared with radical cystectomy alone for muscle-invasive bladder cancer: Japan Clinical Oncology Group Study JCOGAnn Oncol 2014;25(6):1192–8. - PubMed
    1. Grossman HB, Natale RB, Tangen CM, Speights VO, Vogelzang NJ, Trump DL, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med. 2003;349(9):859–66. - PubMed

Publication types

LinkOut - more resources