ABSTRACT
Introduction In the United States, bladder cancer is the fourth most common cancer in men and the eighth most common in women, with transitional cell carcinoma (TCC) comprising nearly 90% of all primary bladder tumors.1 Although the majority of patients present with superficial bladder tumors, 20% to 40% of patients will either present with or ultimately develop muscle-invasive disease. Invasive bladder cancer is a lethal malignancy. If left untreated, over 85% of patients die of the disease within 2 years of the diagnosis.2 Furthermore, in a certain percent of patients with high-grade bladder tumors without involvement of the lamina propria disease will recur/progress and/or fail intravesical management. Such patients may be best treated with an earlier cystectomy when survival outcomes are optimal.3
