Seventy patients with T2-T4 NX MO bladder cancer were treated with intravenous cisplatin (100 mg/m2 q 3-weekly) followed by radiotherapy and/or cystectomy. Objective responses to cisplatin were seen in 57%. For the first group of 50 patients (treated between August 1981 and November 1983), the actuarial survival rate at 2 years was 64%, with a median survival of 20+ months: 81% of deaths occurred within 18 months of entry. Most relapses occurred in the bladder/pelvis. A randomised, controlled study is in progress to assess the true value of this approach to the treatment of invasive bladder cancer.