Cystectomy Remains Standard of Care Following Neoadjuvant Therapy in Patients with Muscle-Invasive Bladder Cancer.
other · Level V
Where this comes from
- Record sourced from PubMed, PMID 42309922.
- Also identified by DOI 10.1016/j.eururo.2026.05.009.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
Radical cystectomy remains the standard of care after neoadjuvant therapy for muscle-invasive bladder cancer. While newer regimens (NIAGRA, KEYNOTE-B15/905) achieve impressive pathological complete response rates, the survival benefits from these trials were built on consolidative surgery, with a 88% cystectomy rate bladder preservation. Clinical complete response agrees with true pathological complete response only about half the time, meaning current restaging tools cannot reliably identify who is truly disease-free. Bladder preservation trials using systemic therapy alone (RETAIN-1/2, HCRN GU 16-257) have shown concerning rates of recurrence and metastasis even with biomarker selection. Trimodal approaches incorporating radiation (IMMUNOPRESERVE, INDIBLADE) are promising but remain early-phase. Until validated biomarkers and prospective trials prove otherwise, cystectomy should remain part of the curative-intent treatment paradigm.