MEDLINE (January 1987 through March 2004, week 2), CANCERLIT (January 1987 through October 2002), and EMBASE (1980 through 2004, week 12) databases were searched for relevant papers. MEDLINE and CANCERLIT were searched using the following medical subject headings: "bladder neoplasms," "carcinoma, transitional cell," "chemotherapy, adjuvant," and "neoadjuvant therapy," EMBASE was searched using the following Excerpta Medica tree terms: "bladder tumor," "bladder cancer," "transitional cell carcinoma," "drug therapy," "chemotherapy," "antineoplastic agents," and "adjuvant therapy." In each database, those subject headings were combined with disease and treatment-specific text words: "bladder neoplasm," "bladder cancer," "bladder carcinoma," "carcinoma of the bladder," "transitional cell carcinoma," "neoadjuvant chemotherapy," "neoadjuvant," and "preoperative." Those terms were then combined with the search terms for the following publication types and study designs: practice guidelines, systematic reviews, meta-analyses, reviews, randomized controlled trials, and controlled clinical trials.
In addition, the Cochrane Library databases (2003, Issue 4) and the conference proceedings of the American Society of Clinical Oncology (ASCO) (1990 through 2003) were searched for abstracts of relevant trials. The Canadian Medical Association Infobase (http://mdm.ca/cpgsnew/cpgs/index.asp) and the National Guideline Clearinghouse (http://www.guideline.gov) were also searched for existing evidence-based practice guidelines.
Relevant articles and abstracts were selected and reviewed by two reviewers, and the reference lists from these sources were searched for additional trials, as were the reference lists from relevant review articles.
Eligibility Criteria
Articles were selected for inclusion in this systematic review of the evidence if they met the following criteria:
- They were fully published reports or abstracts of randomized controlled trials (RCTs) or meta-analyses that:
- compared neoadjuvant chemotherapy and definitive local therapy (cystectomy and/or radical radiotherapy with or without concurrent chemotherapy) with local therapy alone in patients with stage II or stage III transitional cell carcinoma (TCC) of the bladder
- reported comparisons of overall survival and/or progression-free survival
- They were systematic reviews or evidence-based practice guidelines that addressed the guideline question.