Conventional treatment of high-grade, invasive bladder cancer has produced cure rates of only 50percnt; or lower. Systemic cytotoxic chemotherapy has produced response rates of 10ndash;70percnt; in metastatic and recurrent bladder cancer in a series of clinical trials. As a result, cytotoxics have been introduced earlier into the clinical management of invasive bladder cancer, either before and/or after definitive treatment in an attempt to improve treatment results. The current status of these clinical trials of so-called lsquo;neoadjuvantrsquo;, lsquo;perioperativersquo; or lsquo;classic adjuvantrsquo; chemotherapy is reviewed.
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