Follow-up has been much too short to determine five-year disease-free survival. Results of the ongoing randomized clinical trials will have to be reviewed before these combinations are accepted as superior to the "gold standard" of cystectomy.
Stage III or B2 and C
TNM T3, N0, M0
A tumor that invades deeply into muscle (more than halfway through) is designated as T3a, or B2 by the Jewett-Strong Marshall system. If it invades into perivesical fat, it is a T3b, or C by the Jewett-Strong-Marshall system.
About 35 percent of clinical Stage III cases show tumor invasion outside the bladder at the time of surgery, so survival statistics vary. For those having tumors outside the bladder, survival is low— about 20 percent—with most relapsing from distant metastases. Survival rates are much better—30 to 50 percent—for true Stage III cases that have a lower grade and in those cases where the tumor can be downstaged (reduced) after preoperative radiation therapy or chemotherapy alone or after radiation therapy plus cisplatin .
Standard Treatment Cystectomy or radiation therapy (with surgery for salvage if necessary)
