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Stage III Bladder Cancer


    Treatment options:

    1. Radical cystectomy with or without pelvic lymph node dissection.[7]
    2. Neoadjuvant platinum-based combination chemotherapy followed by radical cystectomy.[8]
    3. External-beam radiation therapy (EBRT) with or without concurrent chemotherapy.[3,4,5,6,12,13,14,18]
    4. EBRT with interstitial implantation of radioisotopes.[20]
    5. Segmental cystectomy (in highly selected cases).[21]

    Current Clinical Trials

    Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III bladder cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

    General information about clinical trials is also available from the NCI Web site.


    1. Sell A, Jakobsen A, Nerstrøm B, et al.: Treatment of advanced bladder cancer category T2 T3 and T4a. A randomized multicenter study of preoperative irradiation and cystectomy versus radical irradiation and early salvage cystectomy for residual tumor. DAVECA protocol 8201. Danish Vesical Cancer Group. Scand J Urol Nephrol Suppl 138: 193-201, 1991.
    2. Jenkins BJ, Caulfield MJ, Fowler CG, et al.: Reappraisal of the role of radical radiotherapy and salvage cystectomy in the treatment of invasive (T2/T3) bladder cancer. Br J Urol 62 (4): 343-6, 1988.
    3. Kachnic LA, Kaufman DS, Heney NM, et al.: Bladder preservation by combined modality therapy for invasive bladder cancer. J Clin Oncol 15 (3): 1022-9, 1997.
    4. Housset M, Maulard C, Chretien Y, et al.: Combined radiation and chemotherapy for invasive transitional-cell carcinoma of the bladder: a prospective study. J Clin Oncol 11 (11): 2150-7, 1993.
    5. Tester W, Porter A, Asbell S, et al.: Combined modality program with possible organ preservation for invasive bladder carcinoma: results of RTOG protocol 85-12. Int J Radiat Oncol Biol Phys 25 (5): 783-90, 1993.
    6. Shipley WU, Winter KA, Kaufman DS, et al.: Phase III trial of neoadjuvant chemotherapy in patients with invasive bladder cancer treated with selective bladder preservation by combined radiation therapy and chemotherapy: initial results of Radiation Therapy Oncology Group 89-03. J Clin Oncol 16 (11): 3576-83, 1998.
    7. Smith JA, Crawford ED, Blumenstein B, et al.: A randomized prospective trial of pre-operative irradiation plus radical cystectomy versus surgery alone for transitional cell carcinoma of the bladder: a Southwest Oncology Group study. [Abstract] J Urol 139(4, Part 2): 266A, 1988.
    8. Grossman HB, Natale RB, Tangen CM, et al.: Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 349 (9): 859-66, 2003.
    9. Neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: a randomised controlled trial. International collaboration of trialists. Lancet 354 (9178): 533-40, 1999.
    10. Advanced Bladder Cancer Meta-analysis Collaboration.: Neoadjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis. Lancet 361 (9373): 1927-34, 2003.
    11. Lehmann J, Retz M, Wiemers C, et al.: Adjuvant cisplatin plus methotrexate versus methotrexate, vinblastine, epirubicin, and cisplatin in locally advanced bladder cancer: results of a randomized, multicenter, phase III trial (AUO-AB 05/95). J Clin Oncol 23 (22): 4963-74, 2005.
    12. Gospodarowicz MK, Hawkins NV, Rawlings GA, et al.: Radical radiotherapy for muscle invasive transitional cell carcinoma of the bladder: failure analysis. J Urol 142 (6): 1448-53; discussion 1453-4, 1989.
    13. Yu WS, Sagerman RH, Chung CT, et al.: Bladder carcinoma. Experience with radical and preoperative radiotherapy in 421 patients. Cancer 56 (6): 1293-9, 1985.
    14. Jahnson S, Pedersen J, Westman G: Bladder carcinoma--a 20-year review of radical irradiation therapy. Radiother Oncol 22 (2): 111-7, 1991.
    15. Henningsohn L, Wijkström H, Dickman PW, et al.: Distressful symptoms after radical radiotherapy for urinary bladder cancer. Radiother Oncol 62 (2): 215-25, 2002.
    16. Miller LS: Bladder cancer: superiority of preoperative irradiation and cystectomy in clinical stages B2 and C. Cancer 39 (2 Suppl): 973-80, 1977.
    17. Horwich A, Pendlebury S, Dearnaley DP, et al.: Organ conservation in bladder cancer. Eur J Cancer 31 (Suppl 6): S208-9, 1995.
    18. Coppin CM, Gospodarowicz MK, James K, et al.: Improved local control of invasive bladder cancer by concurrent cisplatin and preoperative or definitive radiation. The National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 14 (11): 2901-7, 1996.
    19. Rödel C, Grabenbauer GG, Kühn R, et al.: Combined-modality treatment and selective organ preservation in invasive bladder cancer: long-term results. J Clin Oncol 20 (14): 3061-71, 2002.
    20. van der Werf-Messing BH, van Putten WL: Carcinoma of the urinary bladder category T2,3NXM0 treated by 40 Gy external irradiation followed by cesium137 implant at reduced dose (50%). Int J Radiat Oncol Biol Phys 16 (2): 369-71, 1989.
    21. Skinner DG: Current perspectives in the management of high-grade invasive bladder cancer. Cancer 45 (7 Suppl): 1866-74, 1980.

    WebMD Public Information from the National Cancer Institute

    Last Updated: February 25, 2014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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