ABSTRACT
Introduction Bladder cancer is the second most common cancer of the genitourinary tract, with some 350,000 new cases worldwide,1 in which one third are locally invasive or metastatic. There is a very high rate of early systemic dissemination. In patients with locally advanced bladder cancer infiltrating the musculature, 5-year survival is dependent upon pathologic stage, grade, and nodal status. As the stage advances, especially when there is cancer that extends outside of the bladder wall, the prognosis worsens. Local or metastatic failure is most often due to occult metastatic disease that was present at the time of initial diagnosis.
