| Inclusion Criteria: | Histologic proof of urothelial cancer; all subtypes except small cell carcinoma as predominant invasive component.
Primary tumors arising in the bladder are elig if: lymphovascular involvement on TUR specimen with>/=cT1 invasion, 3-D mass on EUA (cT3b), or direct invasion of prostatic stroma or the vaginal wall (cT4a)
Pt with more than focal areas of micropapillary Hx are elig, even if they do not meet anatomic criteria for locally advanced disease.
Primary tumors arising in the ureter or renal pelvis are elig if Grade 3 cancers or radiographic abnormality lg enough to recognize as abnormal mass by CT/MRI.
No evidence of disease beyond confines of pelvis by either CT or MRI of the abdomen & pelvis & chest x-ray.Bone scan or no bone pain indicating no evidence of met disease & alk phos<150% ULN or normal bone fraction of alk phos.
Abnormal EKG or history of cardiac disease requires determination of LV function & EF of at least 50% to participate.
Women of childbearing potential must have neg preg test.
Second malig pts OK if expected outcome from the second Cx will not interfere with delivery of therapy or assessment of response in the cystectomy specimen, & expected survival for any prior malignancy is reliably >4 yrs.
Dr. Czerniak will be consulted in equivocal cases of mixed histology, and Dr. Siefker-Radtke will serve as arbiter if questions of eligibility based on histology arise.
Zubrod</=2(3 if recent onsent&due to Cx¬ comorbidity);normal WBC,ANC>/=1800,platelets>150,000(Supranormal values judged benign/inconsequential etiology ok);transaminase</=3xULN, conjugated bili</=1.5mg/dL or (total</=2.5mg/dL);CrC>/=45mL/min. |