HIPEC After Radical Cystectomy for High Risk Bladder Cancer

Inclusion Criteria:

1. Primary urothelial cell carcinoma of the bladder

2. Patient's aged 45-85, both genders.

3. ECOG performance status < 1

4. Hematology: ANC > 1.5x109/L; Platelets > 100x109/L

5. Women with child bearing potential who are negative for pregnancy test (urine or
blood) and who agree to use effective contraceptive method. Reliable contraception
should be used from trial screening and must be continued throughout the study. A
woman of childbearing potential is defined as one who is biologically capable of
becoming pregnant.

6. Signed and dated written informed consent to participate in this clinical trial must
be obtained prior to any study procedure.

Either any of the following preoperative factors for increased risk of recurrence:

7. Lymphovascular invasion

8. Variant histology in the background of primary urothelial (notably plasmacytoid)

9. Clinical T3 or greater

10. Clinical N+

11. No prior neoadjuvant chemotherapy (NAC) or lack of response to NAC

Or any of the following perioperative factors for increased risk of recurrence:

12. Palpable concern for extravesical disease

13. Tumor spillage/bladder entry

14. Suspicious nodes or positive intraoperative frozen sections

Exclusion Criteria:

1. Subjects who have previously undergone intraperitoneal chemotherapy.

2. Subjects with tumor histology other than urothelial cell carcinoma.

3. Patients on concurrent anti-cancer therapy other than that allowed in the study.

4. Other prior malignancies, except for cured non-melanoma skin cancer or curatively
treated in situ carcinoma of the cervix or adequately treated malignancies for which
there has been no evidence of activity for more than 3 years.

5. Subjects with renal insufficiency defined as creatinine > 1.5x the upper limit of
normal or a calculated creatinine clearance of < 50 cc/min.

6. Subjects with a condition which may interfere with the subjects' ability to understand
the requirements of the study.

7. Known HIV, Hepatitis B or Hepatitis C positive.

8. Subjects with uncontrolled concurrent illness including, but not limited to, ongoing
or severe infection requiring antibiotics, symptomatic congestive heart failure,
unstable angina pectoris, acute gastrointestinal bleeding, psychiatric illness or
other condition which in the opinion of the investigator, places the patient at an
unacceptable risk for participation in the study.

9. Any condition that would preclude the ability to deliver appropriate IP therapy.