الفهرس 
ContentsOnly 14 pages are availabe for public view
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Abstract
Radical cystectomy and bilateral pelvic lymphadenectomy remains the standard of care for patients with muscle-invasive bladder cancer. However, the high relapse rates following cystectomy alone for patients with muscle invasive bladder cancer has led to the use of neoadjuvant treatment. Contemporary management of patients with muscle-invasive bladder cancer consists of a multimodal treatment approach comprised of surgery, neoadjuvant chemotherapy, and for select patients, chemoradiation with the objective towards bladder preservation. However, despite the evidence that neoadjuvant cisplatin based chemotherapy improves survival for these patients compared to loco regional treatment alone, less than 20% of patients undergoing radical cystectomy actually receive neoadjuvant chemotherapy. The use of cisplatin-based neoadjuvant chemotherapy for bladder cancer is supported by randomized trials. This demonstrated survival benefit encourages the use of platinum-based combination chemotherapy before RC or definitive radiotherapy, however, the optimal regimen has yet to be determined. This study was conducted on newly diagnosed patients with muscle invasive bladder cancer, All patients were given neoadjuvant chemotherapy MVAC protocol. Both SCC, and TCC showed good response to the neoadjuvant chemotherapy protocol M VAC. The administration of MVC as a neoadjuvant seems to be well tolerated. The overall survival was better in patients who underwent surgery compared to those who received definitive radiotherapy. At the end of this study, we concluded that utility of neoadjuvant chemotherapy protocol MVAC is considered safe and effective in MIBC whatever the histologic variant of bladder cancer. Finally, we confirmed the safety and efficacy of MVAC protocol as neoadjuvant chemotherapy in muscle invasive bladder cancer, further phase III studies in comparison to other protocols are recommended to conclude the ideal neoadjuvant regimen.