Abstract

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• Bladder cancer, one of the first cancers associated with industrialization, is not unexpectedly increasing in incidence throughout the world. Despite the increasing incidence of bladder cancer, mortality has actually decreased in recent years. In advanced and metastatic bladder cancer, the platinum/methotrexate-based combination of chemotherapy may be responsible for this improved survival. However, chemotherapy appears not to have influenced survival in patients with superficial disease. Increasing evidence suggests that bacillus calmette-Guérin immunotherapy can reduce both disease progression and mortality.