[When is surgical treatment indicated in metastatic urothelial carcinoma and what is the scientific rationale?]

BACKGROUND: Patients with metastatic urothelial carcinoma have a poor prognosis. Standard of care is a systemic chemotherapy but surgical excision of metastasis can be performed in individual approaches.

OBJECTIVES: To evaluate treatment options and study results and to identify and discuss advantages and disadvantages of metastasectomy in urothelial carcinoma.

MATERIALS AND METHODS: Database analysis and discussion of clinical trials concerning metastasectomy in urothelial carcinoma.

RESULTS: In individual cases, metastasectomy can be a reasonable additional therapeutic approach to systemic chemotherapy. Especially patients suffering from symptomatic metastatic disease benefit from extended surgical effort but further effects on survival cannot be expected.

CONCLUSIONS: Patients undergoing metastasetomy should be well selected concerning general physical condition. Metastasectomy in urothelial carcinoma remains an individual therapeutic approach and should be performed in combination with systemic chemotherapy.