Intravenous cis-platinum for invasive bladder cancer. Safety and feasibility of a new approach.

The five-year survival rate of patients with locally invasive bladder cancer (stages T3-T4, Nx, Mo) is less than 50% whatever treatment is given. In an effort to improve the prognosis of patients with this disease, we have incorporated into a management protocol two cycles of intravenous administration of cis-platinum before surgery or radiotherapy (which function as the "definitive" treatment). In 10 of the first 12 patients treated, tumour necrosis has been demonstrated histologically, and definite clinical responses have been observed in eight patients after two cycles of cis-platinum treatment. The toxicity has been acceptable, and subsequent management has not been compromised.