Neoadjuvant chemotherapy for muscle-invasive bladder cancer: Underused across the 49th parallel

Despite local control with surgery or radiation, more than 50% of patients with muscle-invasive bladder cancer (MIBC) will relapse and die from distant metastases.1 Micrometastatic deposits, present at the time of diagnosis but smaller than the detection threshold of modern imaging, are believed to be responsible for these relapses. Perioperative chemotherapy can eradicate these micrometastases