Surgery and adjuvant chemotherapy with high-dose methotrexate and folinic acid rescue for infiltrating tumors of the bladder.

Thirty-three patients with category T3 or T4 bladder cancer were treated by partial or total cystectomy followed by 6 to 12 courses of high-dose methotrexate (HDMTX) with folinic acid rescue. Survival at 2 years was 90%. Two patients were treated palliatively with HDMTX alone, one of whom is alive and disease free after 35 months.