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Bladder cancer is the second most common malignancy of the genito-urinary system.
During the past 20 years many phase II clinical trials have investigated the role of chemotherapy in patients with locally advanced bladder cancer. These studies have identified a number of active single-agent cytotoxic drugs such as cisplatin. Despite this, many clinicians now use neoadjuvant chemotherapy in the routine treatment of locally advanced bladder cancer. The main objective of this review was to investigate whether platinum-based chemotherapy given either before or during local treatment, improves the survival of patients with locally advanced bladder cancer. A further objective was to determine whether there is any evidence that such chemotherapy is more or less effective within well defined subgroups of patients.