Management of metastatic urothelial cancer: the role of surgery as an adjunct to chemotherapy

Abstract

Metastatic or unresectable disease is identified in approximately20% of patients presenting with invasive urothelial cancer. Inaddition, up to 50% of patients will develop metastases followingradical cystectomy for clinically localized disease. Multiagentcisplatin-based chemotherapy is considered standard first-linetreatment for these patients. Although urothelial cancer is considereda chemosensitive tumour, metastatic disease is associatedwith poor prognosis and short-term survival. Here, we review therole of a multidisciplinary approach to treating patients with metastaticurothelial cancer.