Bladder cancer represents a major challenge to the oncologist. In spite of new tech niques for early diagnosis and innovative imaging procedures for staging, the outcome in terms of cure has not improved during the past ten years. Fortunately, about 74% of the patients present with localized disease, with 18% presenting with localized and regional disease, and 3% with distant metastases at diagnosis. In accordance with the stage at presentation, 94% of patients with localized disease are controlled at 5 years, as are 50% of patients with local and regional disease but un fortunately only 7% of those with distant disease. The survival data for Afro-Americans are more grave, with only 79% of patients with localized disease surviving at 5 years, 38% with local and regional disease, and 4% with disseminated disease. Even after 5 years, however, patients continue to fail not only locally and regionally but also with disseminated disease, thereby creating enigmas as to the continued influence of basic molecular changes, basic etiologic agents, and unsuspected more advanced disease, as well as demonstrating the inadequacies of local surgical treatment programs. These factors have led to braoder programs of combined integrated multimodal treatment earlier in the course of the disease process. Clearly, these newer innovative programs have placed increasing emphasis on the combination of surgery with radiation therapy and chemotherapy.
This volume provides up-to-date information on the diagnosis and treatment of carcinoma of the bladder and will appeal to all physicians concerned with this field. Advances in molecular genetics that are of importance to clinical practice are discussed in depth. Progress in both imaging and nonimaging modalities is well documented and critically evaluated in a manner that will prove invaluable for practicing uro-oncologists. Furthermore, the management of patients with superficial, muscle-invasive, and advanced disease is discussed, and new treatment results presented. The numerous illustrations and tables will serve to assist the reader in understanding the presented data.
1 Epidemiology of Bladder Cancer.- 2 Natural History of Bladder Carcinoma.- 3 Prognostic Factors in Bladder Cancer: Emphasis on Immunohistochemical Analysis.- 4 Molecular Genetics in Carcinoma of the Bladder.- 5 Pathology of Bladder Cancer.- 6 Imaging Modalities in the Diagnosis and Staging of Carcinoma of the Bladder.- 7 Contemporary Nonimaging Methods in the Diagnosis and Prognosis of Carcinoma of the Bladder.- 8 Staging of Bladder Cancer.- 9 Photodynamic Therapy of Bladder Cancer.- 10 Fluorescence Detection of Bladder Cancer.- 11 Treatment of Ta, T1 Bladder Tumors: Recent Results of the EORTC-GU Group.- 12 Surgical Treatment of Carcinoma of the Bladder: The USC Experience.- 13 Prophylactic Urethrectomy: When and How?.- 14 Orthotopic Reconstruction Following Radical Cystectomy: The USC Experience.- 15 Complications of Radical Cystectomy.- 16 Long-term Results of Brachytherapy with Iridium-192 Implants.- 17 Bladder-Conserving Therapy for Invasive Bladder Cancer Using Transurethral Surgery, Chemotherapy, and Radiation Therapy with Patient Selection by Initial Treatment Response.- 18 Muscle-Invasive Bladder Cancer: Transurethral Resection and Radiochemotherapy as an Organ-Sparing Treatment Option.- 19 External Radiotherapy in the Treatment of Muscle-Invasive Transitional Cell Carcinoma of the Bladder.- 20 Chemotherapy Before Definitive Treatment for Locally Advanced Bladder Cancer.- 21 Continuous Infusion Chemotherapy and Irradiation in the Treatment of Advanced Bladder Carcinoma.- 22 Postoperative Chemotherapy for Bladder Carcinoma.- 23 Management of Patients with Pelvic Recurrence Following Radical Cystectomy.- 24 Management of Patients with Failure Following Definitive Radiotherapy.- 25 Treatment-Related Complications for Bladder Carcinoma: Radical Surgery Versus Bladder-Preserving Techniques.- 26 Special Considerations in the Management of Carcinoma in the Neurogenic Bladder.- 27 Hyperthermia in Bladder Cancer.- 28 Management of Patients with Metastatic Carcinoma of the Blader.- 29 National Differences in the Management of Bladder Cancer.- List of Contributors.