In muscle-invasive bladder cancer (MIBC, T2–T4a N0M0), the SWOG 8710 trial established which treatment as the standard of care over radical cystectomy alone?

• A Adjuvant gemcitabine-cisplatin chemotherapy after radical cystectomy
• B Definitive chemoradiotherapy (bladder preservation protocol) replacing radical cystectomy
• C Neoadjuvant immunotherapy (pembrolizumab) followed by radical cystectomy
• D Neoadjuvant methotrexate-vinblastine-doxorubicin-cisplatin (MVAC) chemotherapy followed by radical cystectomy ✓

Explanation

The SWOG 8710 (Intergroup) trial demonstrated that neoadjuvant MVAC chemotherapy (3 cycles) followed by radical cystectomy significantly improved median overall survival (77 months vs. 46 months) and 5-year OS compared to cystectomy alone, establishing neoadjuvant cisplatin-based chemotherapy as the standard of care for MIBC. Gemcitabine-cisplatin (GC) subsequently proved equivalent efficacy with less toxicity in the metastatic setting and is commonly substituted. Adjuvant chemotherapy data are less robust.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.