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Matthew D. Galsky, Harry W. Herr and Dean F. Bajorin

Despite surgery with curative intent, approximately 50% of patients with muscle-invasive transitional cell carcinoma of the bladder will develop distant metastases and succumb to their disease. Attempts to improve outcomes have focused on refining surgical techniques and integrating perioperative chemotherapy. This review summarizes the available literature addressing the role of pelvic lymphadenectomy, neoadjuvant chemotherapy, and adjuvant chemotherapy in the management of patients with muscle-invasive transitional cell carcinoma of bladder.