Rethinking Radical Cystectomy as the Best Choice for Most Patients With Muscle-Invasive Bladder Cancer.

Should radical cystectomybeconsideredanalternative treatment to bladder preservation trimodality therapy in patients with muscle-invasive bladder cancer?—Yes. For the first time, the question is formulated correctly, and for the first time, based on new published evidence in 2015,1 bladder preservation trimodality therapy should be considered first for patients with muscle-invasive bladder cancer (MIBC), with cystectomy reserved for patients unable or unwilling to undergo bladder preservation or as a salvage option for local recurrences.