A Review of Neoadjuvant and Adjuvant Chemotherapy for Nonmetastatic Muscle Invasive Bladder Cancer
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
INTRODUCTION: Radical cystectomy is the standard treatment for muscle invasive bladder cancer but survival remains poor with radical cystectomy alone. We reviewed the relevant available data on adjuvant and neoadjuvant chemotherapy for bladder cancer. METHODS: We performed a MEDLINE® database literature search to identify original articles and meta-analyses. A key word search was done using the terms urinary bladder neoplasms, cystectomy, chemotherapy, and adjuvant and neoadjuvant therapy. The search was restricted to adults. RESULTS: We studied adjuvant chemotherapy in several prospective, randomized trials that demonstrated improvement in disease-free survival. Many of the trials failed to achieve the target number of accruals, closed early or had major flaws in design. Evidence of the use of neoadjuvant chemotherapy was based on more robust studies that showed a small but significant 5% improvement in overall survival. However this benefit concerned a small set of patients who responded to chemotherapy while another set seemed to fare well with or without neoadjuvant chemotherapy. CONCLUSIONS: Perioperative chemotherapy improves survival in patients with muscle invasive bladder cancer. Molecular predictors of the response to chemotherapy are still in the investigational phase and not yet incorporated into clinical practice. Thus, a risk adapted approach by reserving neoadjuvant chemotherapy for cisplatin eligible patients with high risk disease features may balance the benefits of neoadjuvant chemotherapy while minimizing overtreatment.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it