Chemotherapy of bladder cancer is based on the methotrexate-vinblastine-cysplatinum (M-VAC) protocole. The neo-adjuvant therapy sterilizes 20% of the bladders, but the criteria of effectiveness are not precise enough to recognize the patients. Surgical indications have not been modified by this chemotherapy. The effectiveness of adjuvant chemotherapy has not yet been firmly established; it seems therefore reasonable to reserve it for cancers with poor prognosis. Intravesical chemotherapy has been abandoned to be replaced by BCG.
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