{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:56:43Z","timestamp":1776261403551,"version":"3.50.1"},"reference-count":66,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>When bladder cancer recurs after bacillus Calmette\u2013Gu\u00e9rin (BCG) for high-risk non-muscle-invasive disease, after trimodal therapy (TMT), or after other bladder-preserving therapy for muscle-invasive disease, patients face time-sensitive decisions that determine whether cure remains achievable. Treating physicians must guide these choices by balancing oncologic safety with quality of life, comorbidities, and patient preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed 2024\u20132025 guidelines from the American Urological Association\/Society of Urologic Oncology (AUA\/SUO), National Comprehensive Cancer Network (NCCN), and European Association of Urology (EAU), while incorporating pivotal trials and recent drug approvals. Emphasis was placed on translating recommendations into practical decision-making for clinicians and patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For post-BCG recurrence, early radical cystectomy (RC) offers the highest chance of cure for medically fit patients and is recommended throughout all three guidelines. When surgery is not possible or declined, bladder-sparing therapies, including four recently US Food and Drug Administration (FDA)-approved drugs, can be considered with strict surveillance. In post-TMT recurrence, RC is standard for invasive relapse, with bladder preservation reserved for select noninvasive cases. In both settings, optimal outcomes require timely workup, presentation of all viable options, and coordination of multidisciplinary input with a strong emphasis on close surveillance and follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Management of bladder cancer recurrence is optimized when therapy aligns with patient goals while safeguarding oncologic outcomes. Regardless of the path chosen, early engagement of a multidisciplinary team and shared decision-making are essential to delivering the best possible care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-19129-8","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T13:43:27Z","timestamp":1770731007000},"page":"4873-4884","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ASO Practice Guidelines Series: Surgical Management of Bladder Cancer Relapse"],"prefix":"10.1245","volume":"33","author":[{"given":"Can","family":"Aydogdu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean T.","family":"McSweeney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vignesh T.","family":"Packiam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Bukavina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"issue":"6 Suppl 4","key":"19129_CR1","first-page":"S199","volume":"3","author":"AR Zlotta","year":"2009","unstructured":"Zlotta AR, Fleshner NE, Jewett MA. The management of BCG failure in non-muscle-invasive bladder cancer: an update. Can Urol Assoc J. 2009;3(6 Suppl 4):S199-205.","journal-title":"Can Urol Assoc J"},{"issue":"2","key":"19129_CR2","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.juro.2017.08.106","volume":"199","author":"A Sanchez","year":"2018","unstructured":"Sanchez A, Wszolek MF, Niemierko A, Clayman RH, Drumm M, Rodr\u00edguez D, Efstathiou JA. Incidence, clinicopathological risk factors, management and outcomes of nonmuscle invasive recurrence after complete response to trimodality therapy for muscle invasive bladder cancer. J Urol. 2018;199(2):407\u201315.","journal-title":"J Urol"},{"issue":"6","key":"19129_CR3","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1016\/S1470-2045(23)00170-5","volume":"24","author":"AR Zlotta","year":"2023","unstructured":"Zlotta AR, Ballas LK, Niemierko A, Lajkosz K, Kuk C, Miranda G, Efstathiou JA. Radical cystectomy versus trimodality therapy for muscle-invasive bladder cancer: a multi-institutional propensity score matched and weighted analysis. Lancet Oncol. 2023;24(6):669\u201381.","journal-title":"Lancet Oncol"},{"issue":"16","key":"19129_CR4","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1056\/NEJMoa1106106","volume":"366","author":"ND James","year":"2012","unstructured":"James ND, Hussain SA, Hall E, Jenkins P, Tremlett J, Rawlings C, Huddart RA. Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med. 2012;366(16):1477\u201388.","journal-title":"N Engl J Med"},{"issue":"20","key":"19129_CR5","doi-asserted-by":"publisher","first-page":"2299","DOI":"10.1200\/JCO.2016.69.2327","volume":"35","author":"GS Kulkarni","year":"2017","unstructured":"Kulkarni GS, Hermanns T, Wei Y, Bhindi B, Satkunasivam R, Athanasopoulos P, Zlotta AR. Propensity score analysis of radical cystectomy versus bladder-sparing trimodal therapy in the setting of a multidisciplinary bladder cancer clinic. J Clin Oncol. 2017;35(20):2299\u2013305.","journal-title":"J Clin Oncol"},{"issue":"6","key":"19129_CR6","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1016\/j.eururo.2016.12.020","volume":"71","author":"NJ Giacalone","year":"2017","unstructured":"Giacalone NJ, Shipley WU, Clayman RH, Niemierko A, Drumm M, Heney NM, Michaelson MD, Lee RJ, Saylor PJ, Wszolek MF, Feldman AS, Dahl DM, Zietman AL, Efstathiou JA. Long-term Outcomes After Bladder-preserving Tri-modality Therapy for Patients with Muscle-invasive Bladder Cancer: An Updated Analysis of the Massachusetts General Hospital Experience. Eur Urol. 2017 Jun;71(6):952-960. https:\/\/doi.org\/10.1016\/j.eururo.2016.12.020","journal-title":"Eur Urol"},{"key":"19129_CR7","unstructured":"Gontero PAB, Comp\u00e9rat E, Dominguez Escrig JL, Liedberg F, Mariappan P, Masson-Lecomte A, van Rhijn BWG, Seisen T, Shariat SF, Teoh J, Xylinas EN, EAU Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and CIS). Arnhem: EAU Guidelines Office. 2025"},{"key":"19129_CR8","doi-asserted-by":"crossref","unstructured":"van der Heijden AG, HMB, Carrion A, Cathomas R, Comp\u00e9rat EM, Dimitropoulos K, Efstathiou JA, Fietkau R, Lorch A, Mariappan P, Meijer RP, Mertens LS, Milowsky MI, Neuzillet Y, Panebianco V, Rink M, Thalmann GN, EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer. Arnhem: EAU Guidelines Office. 2025","DOI":"10.1016\/j.eururo.2025.02.019"},{"issue":"1","key":"19129_CR9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/JU.0000000000003981","volume":"212","author":"J Holzbeierlein","year":"2024","unstructured":"Holzbeierlein J, Bixler BR, Buckley DI, Chang SS, Holmes RS, James AC, Schuckman A. Treatment of non-metastatic muscle-invasive bladder cancer: AUA\/ASCO\/SUO guideline (2017; amended 2020, 2024). J Urol. 2024;212(1):3\u201310.","journal-title":"J Urol"},{"issue":"4","key":"19129_CR10","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1097\/JU.0000000000003846","volume":"211","author":"JM Holzbeierlein","year":"2024","unstructured":"Holzbeierlein JM, Bixler BR, Buckley DI, Chang SS, Holmes R, James AC, Schuckman AK. Diagnosis and treatment of non-muscle invasive bladder cancer: AUA\/SUO guideline: 2024 amendment. J Urol. 2024;211(4):533\u20138.","journal-title":"J Urol"},{"key":"19129_CR11","unstructured":"Network, N.C.C. NCCN Clinical Practise Guidelines in Oncology (NCCN Guidelines), Bladder Cancer (Version 2.2025). 2025 25.11.2025]. Available from: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/bladder.pdf"},{"issue":"2","key":"19129_CR12","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.eururo.2012.07.033","volume":"63","author":"M Burger","year":"2013","unstructured":"Burger M, Catto JW, Dalbagni G, Grossman HB, Herr H, Karakiewicz P, Lotan Y. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2013;63(2):234\u201341.","journal-title":"Eur Urol"},{"issue":"5","key":"19129_CR13","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1016\/j.eururo.2006.01.017","volume":"49","author":"JA Witjes","year":"2006","unstructured":"Witjes JA. Management of BCG failures in superficial bladder cancer: a review. Eur Urol. 2006;49(5):790\u20137.","journal-title":"Eur Urol"},{"issue":"2","key":"19129_CR14","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1001\/jamaoncol.2022.5985","volume":"9","author":"S Agrawal","year":"2023","unstructured":"Agrawal S, Arora S, Amiri-Kordestani L, de Claro RA, Fashoyin-Aje L, Gormley N, Beaver JA. Use of single-arm trials for US Food and Drug Administration drug approval in oncology, 2002\u20132021. JAMA Oncol. 2023;9(2):266\u201372.","journal-title":"JAMA Oncol"},{"key":"19129_CR15","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.euros.2022.12.016","volume":"49","author":"H Collacott","year":"2023","unstructured":"Collacott H, Krucien N, Heidenreich S, Catto JW, Ghatnekar O. Patient preferences for treatment of bacillus calmette-gu\u00e9rin\u2013unresponsive non\u2013muscle-invasive bladder cancer: a cross-country choice experiment. Eur Urol Open Sci. 2023;49:92\u20139.","journal-title":"Eur Urol Open Sci"},{"key":"19129_CR16","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.euros.2023.04.013","volume":"53","author":"WS Tan","year":"2023","unstructured":"Tan WS, Grajales V, Contieri R, Hensley P, Bree K, Msaouel P, Kamat AM. Bladder-sparing treatment in patients with bacillus Calmette-Guerin\u2013unresponsive non\u2013muscle-invasive bladder cancer: an analysis of long-term survival outcomes. Eur Urol Open Sci. 2023;53:16\u201322.","journal-title":"Eur Urol Open Sci"},{"issue":"7","key":"19129_CR17","doi-asserted-by":"publisher","first-page":"436.e1","DOI":"10.1016\/j.urolonc.2021.01.004","volume":"39","author":"VT Packiam","year":"2021","unstructured":"Packiam VT, Labbate CV, Boorjian SA, Tarrell R, Cheville JC, Avulova S, Sharma V, Tsivian M, Adamic B, Mahmoud M, Werntz RP, Smith ND, Karnes RJ, Tollefson MK, Steinberg GD, Frank I. The association of salvage intravesical therapy following BCG with pathologic outcomes and survival after radical cystectomy for patients with high-grade non-muscle invasive bladder cancer: A multi-institution analysis. Urol Oncol. 2021 Jul;39(7):436.e1-436.e8. https:\/\/doi.org\/10.1016\/j.urolonc.2021.01.004","journal-title":"Urol Oncol"},{"issue":"2","key":"19129_CR18","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1111\/bju.16509","volume":"135","author":"JI Taylor","year":"2025","unstructured":"Taylor JI, Kamat AM, O\u2019Donnell MA, Annapureddy D, Howard J, Tan WS, Lotan Y. Long-term outcomes of bladder-sparing therapy vs radical cystectomy in BCG-unresponsive non-muscle-invasive bladder cancer. BJU Int. 2025;135(2):260\u20138.","journal-title":"BJU Int"},{"key":"19129_CR19","doi-asserted-by":"crossref","unstructured":"McElree IM, Steinberg RL, Hougen HY, Mott SL, Packiam VT, O'Donnell MA. Long\u2010term outcomes of a cascading salvage strategy for high\u2010risk non\u2010muscle\u2010invasive bladder cancer. BJU Int. 2025","DOI":"10.1111\/bju.70044"},{"issue":"1","key":"19129_CR20","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1186\/s12885-023-11605-8","volume":"23","author":"JL Gore","year":"2023","unstructured":"Gore JL, Wolff EM, Comstock BA, Follmer KM, Nash MG, Basu A, Smith AB. Protocol of the Comparison of Intravesical Therapy and Surgery as Treatment Options (CISTO) study: a pragmatic, prospective multicenter observational cohort study of recurrent high-grade non-muscle invasive bladder cancer. BMC Cancer. 2023;23(1):1127.","journal-title":"BMC Cancer"},{"issue":"52","key":"19129_CR21","first-page":"e3","volume":"213","author":"JL Gore","year":"2025","unstructured":"Gore JL, Wolff EM, Nash MG, Comstock BA, Gilbert SM, Wright JL, Collaborative CISTO. Radical cystectomy versus bladder-sparing therapy for recurrent high-grade non-muscle invasive bladder cancer: results from the Comparison of Intravesical Therapy and Surgery as Treatment Options (CISTO) study. J Urology. 2025;213(52):e3.","journal-title":"J Urology"},{"issue":"6","key":"19129_CR22","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1517\/14656566.2.6.1009","volume":"2","author":"GD Steinberg","year":"2001","unstructured":"Steinberg GD, Kuznetsov DD, O\u2019Connor RC, Alsikafi NF. Intravesical valrubicin in the treatment of carcinoma in situ of the bladder. Expert Opin Pharmacother. 2001;2(6):1009\u201313.","journal-title":"Expert Opin Pharmacother"},{"issue":"5","key":"19129_CR23","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1177\/1756287214541798","volume":"6","author":"MS Cookson","year":"2014","unstructured":"Cookson MS, Chang SS, Lihou C, Li T, Harper SQ, Lang Z, Tutrone RF. Use of intravesical valrubicin in clinical practice for treatment of nonmuscle-invasive bladder cancer, including carcinoma in situ of the bladder. Ther Adv Urol. 2014;6(5):181\u201391.","journal-title":"Ther Adv Urol"},{"issue":"4","key":"19129_CR24","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1038\/nrurol.2017.16","volume":"14","author":"AM Kamat","year":"2017","unstructured":"Kamat AM, Colombel M, Sundi D, Lamm D, Boehle A, Brausi M, Witjes JA. BCG-unresponsive non-muscle-invasive bladder cancer: recommendations from the IBCG. Nat Rev Urol. 2017;14(4):244\u201355.","journal-title":"Nat Rev Urol"},{"issue":"5","key":"19129_CR25","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1097\/JU.0000000000000688","volume":"203","author":"RL Steinberg","year":"2020","unstructured":"Steinberg RL, Thomas LJ, Brooks N, Mott SL, Vitale A, Crump T, O\u2019Donnell MA. Multi-institution evaluation of sequential gemcitabine and docetaxel as rescue therapy for nonmuscle invasive bladder cancer. J Urol. 2020;203(5):902\u20139.","journal-title":"J Urol"},{"issue":"1","key":"19129_CR26","doi-asserted-by":"publisher","first-page":"65","DOI":"10.3233\/BLC-150008","volume":"1","author":"RL Steinberg","year":"2015","unstructured":"Steinberg RL, Thomas LJ, O\u2019Donnell MA, Nepple KG. Sequential intravesical gemcitabine and docetaxel for the salvage treatment of non-muscle invasive bladder cancer. Bladder Cancer. 2015;1(1):65\u201372.","journal-title":"Bladder Cancer"},{"issue":"3","key":"19129_CR27","doi-asserted-by":"publisher","first-page":"148.e1","DOI":"10.1016\/j.urolonc.2022.10.030","volume":"41","author":"PT Chevuru","year":"2023","unstructured":"Chevuru PT, McElree IM, Mott SL, Steinberg RL, O'Donnell MA, Packiam VT. Long-term follow-up of sequential intravesical\ngemcitabine and docetaxel salvage therapy for non-muscle invasive bladder cancer. Urol Oncol. 2023 Mar;41(3):148.e1-148.e7. https:\/\/doi.org\/10.1016\/j.urolonc.2022.10.030. Epub 2022 Nov 28. PMID: 36456454.","journal-title":"Urol Oncol"},{"issue":"6","key":"19129_CR28","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1111\/bju.16645","volume":"135","author":"P Scilipoti","year":"2025","unstructured":"Scilipoti P, Longoni M, De Angelis M, Zaurito P, Massiet A, Dutto D, Urothelial Carcinoma Working Group. Gemcitabine and docetaxel for high-risk non-muscle-invasive bladder cancer: EuroGemDoce group results. BJU international. 2025;135(6):969\u201376.","journal-title":"BJU international"},{"issue":"4","key":"19129_CR29","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.euf.2023.06.006","volume":"9","author":"M Kates","year":"2023","unstructured":"Kates M, Chu X, Hahn N, Pietzak E, Smith A, Shevrin DH, Carducci M. Background and update for ECOG-ACRIN EA8212: A randomized Phase 3 trial of intravesical Bacillus Calmette-Gu\u00e9rin (BCG) versus Intravesical docetaxel and gemcitabine treatment in BCG-na\u00efve high-grade non\u2013muscle-invasive bladder cancer (BRIDGE). Eur Urol Focus. 2023;9(4):561.","journal-title":"Eur Urol Focus"},{"key":"19129_CR30","unstructured":"KEYTRUDA\u00ae (pembrolizumab) injection, for intravenous use. Prescribing information. Merck Sharp & Dohme LLC. 2025 18.09.2025]. Available from: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2025\/125514s178lbl.pdf"},{"key":"19129_CR31","unstructured":"ADSTILADRIN\u00ae (nadofaragene firadenovec-vncg). Prescribing information. Ferring Pharmaceuticals. 2024 18.09.2025]. Available from: https:\/\/www.fda.gov\/files\/vaccines%2C%20blood%20%26%20biologics\/published\/Package-Insert-ADSTILADRIN-.pdf"},{"key":"19129_CR32","unstructured":"ANKTIVA\u00ae (nogapendekin alfa inbakicept-pmln) solution, for intravesical use. Prescribing information. ImmunityBio, Inc. 2024 18.09.2025]. Available from: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2024\/761336s000lbl.pdf"},{"key":"19129_CR33","unstructured":"INLEXZO (gemcitabine intravesical system). Prescribing information. Janssen Biotech, Inc. 2025 18.09.2025]. Available from: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2025\/219683s000lbl.pdf"},{"issue":"4_suppl","key":"19129_CR34","doi-asserted-by":"publisher","first-page":"TPS722","DOI":"10.1200\/JCO.2024.42.4_suppl.TPS722","volume":"42","author":"ND Shore","year":"2024","unstructured":"Shore ND, Nishiyama H, Shariat SF, Steinberg G, Kamat AM, Alanee SR, Hahn NM. Phase 3 KEYNOTE-676 cohort A: Bacillus Calmette-Gu\u00e9rin (BCG) with or without pembrolizumab for high-risk (HR) non\u2013muscle-invasive bladder cancer (NMIBC) that persists\/recurs after BCG induction. J Clin Oncol. 2024;42(4_suppl):TPS722\u2013TPS722.","journal-title":"J Clin Oncol"},{"issue":"19","key":"19129_CR35","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1056\/NEJMoa2408154","volume":"391","author":"T Powles","year":"2024","unstructured":"Powles T, Catto JW, Galsky MD, Al-Ahmadie H, Meeks JJ, Nishiyama H, Van Der Heijden MS. Perioperative durvalumab with neoadjuvant chemotherapy in operable bladder cancer. NEJM. 2024;391(19):1773\u201386.","journal-title":"NEJM"},{"issue":"11","key":"19129_CR36","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1093\/annonc\/mdz296","volume":"30","author":"A Horwich","year":"2019","unstructured":"Horwich A, Babjuk M, Bellmunt J, Bruins HM, De Reijke TM, De Santis M, Witjes JA. EAU\u2013ESMO consensus statements on the management of advanced and variant bladder cancer\u2014an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees. Ann Oncol. 2019;30(11):1697\u2013727.","journal-title":"Ann Oncol"},{"issue":"34","key":"19129_CR37","doi-asserted-by":"publisher","first-page":"3801","DOI":"10.1200\/JCO.2014.57.5548","volume":"32","author":"RH Mak","year":"2014","unstructured":"Mak RH, Hunt D, Shipley WU, Efstathiou JA, Tester WJ, Hagan MP, Zietman AL. Long-term outcomes in patients with muscle-invasive bladder cancer after selective bladder-preserving combined-modality therapy: a pooled analysis of Radiation Therapy Oncology Group Protocols 8802, 8903, 9506, 9706, 9906, and 0233. J Clin Oncol. 2014;32(34):3801\u20139.","journal-title":"J Clin Oncol"},{"issue":"6","key":"19129_CR38","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1007\/s00345-015-1710-5","volume":"34","author":"E Suer","year":"2016","unstructured":"Suer E, Hamidi N, Gokce MI, Gulpinar O, Turkolmez K, Beduk Y, Baltaci S. Significance of second transurethral resection on patient outcomes in muscle-invasive bladder cancer patients treated with bladder-preserving multimodal therapy. World J Urol. 2016;34(6):847\u201351.","journal-title":"World J Urol"},{"issue":"3","key":"19129_CR39","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/S0090-4295(01)01219-5","volume":"58","author":"AL Zietman","year":"2001","unstructured":"Zietman AL, Grocela J, Zehr E, Kaufman DS, Young RH, Althausen AF, Shipley WU. Selective bladder conservation using transurethral resection, chemotherapy, and radiation: management and consequences of Ta, T1, and Tis recurrence within the retained bladder. Urology. 2001;58(3):380\u20135.","journal-title":"Urology"},{"issue":"2","key":"19129_CR40","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.juro.2011.09.159","volume":"187","author":"JR Eswara","year":"2012","unstructured":"Eswara JR, Efstathiou JA, Heney NM, Paly J, Kaufman DS, McDougal WS, Shipley WU. Complications and long-term results of salvage cystectomy after failed bladder sparing therapy for muscle invasive bladder cancer. J Urol. 2012;187(2):463\u20138.","journal-title":"J Urol"},{"key":"19129_CR41","doi-asserted-by":"crossref","unstructured":"Pyrgidis N, Schulz GB, Scilipoti P, Pellegrino F, Casuscelli J, Tzelves L, Moschini M. The role of salvage cystectomy after prior trimodality therapy: a multinational match-paired analysis. Eur Urol Focus. 2025","DOI":"10.1200\/JCO.2025.43.5_suppl.781"},{"issue":"1","key":"19129_CR42","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/JU.0000000000001696","volume":"206","author":"A Pieretti","year":"2021","unstructured":"Pieretti A, et al. Complications and outcomes of salvage cystectomy after trimodality therapy. J Urol. 2021;206(1):29\u201336.","journal-title":"J Urol"},{"issue":"1","key":"19129_CR43","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s00345-010-0603-x","volume":"29","author":"SP Elliott","year":"2011","unstructured":"Elliott SP, Malaeb BS. Long-term urinary adverse effects of pelvic radiotherapy. World J Urol. 2011;29(1):35\u201341.","journal-title":"World J Urol"},{"issue":"11","key":"19129_CR44","doi-asserted-by":"publisher","first-page":"786.e1","DOI":"10.1016\/j.urolonc.2021.03.009","volume":"39","author":"R Rodrigues Pessoa","year":"2021","unstructured":"Rodrigues Pessoa R, Mueller AC, Boxley P, Flaig TW, Piper C, Konety B, Yu JB, Gershman B, Kukreja J, Kim SP. Systematic review and meta-analysis of radiation therapy for high-risk non-muscle invasive bladder cancer. Urol Oncol. 2021 Nov;39(11):786.e1-786.e8. https:\/\/doi.org\/10.1016\/j.urolonc.2021.03.009. Epub 2021 Apr 10. PMID: 33846085.","journal-title":"Urol Oncol"},{"issue":"34","key":"19129_CR45","doi-asserted-by":"publisher","first-page":"4095","DOI":"10.1200\/JCO.23.02510","volume":"42","author":"DM Dahl","year":"2024","unstructured":"Dahl DM, Rodgers JP, Shipley WU, Michaelson MD, Wu CL, Parker W, Efstathiou JA. Bladder-preserving trimodality treatment for high-grade T1 bladder cancer: results from phase II protocol NRG Oncology\/RTOG 0926. J Clin Oncol. 2024;42(34):4095\u2013102.","journal-title":"J Clin Oncol"},{"issue":"5","key":"19129_CR46","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.eururo.2025.05.027","volume":"88","author":"MZ Fu","year":"2025","unstructured":"Fu MZ, Ghodoussipour S, Packiam VT. Re: bladder-preserving trimodality treatment for high-grade T1 bladder cancer: results from phase II protocol NRG Oncology\/RTOG 0926. Eur Urol. 2025;88(5):530\u20131.","journal-title":"Eur Urol"},{"issue":"3","key":"19129_CR47","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/j.juro.2017.04.086","volume":"198","author":"SS Chang","year":"2017","unstructured":"Chang SS, Bochner BH, Chou R, Dreicer R, Kamat AM, Lerner SP, Lotan Y, Meeks JJ, Michalski JM, Morgan TM, Quale DZ, Rosenberg JE, Zietman AL, Holzbeierlein JM. Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: AUA\/ASCO\/ASTRO\/SUO Guideline. J Urol. 2017 Sep;198(3):552-559. https:\/\/doi.org\/10.1016\/j.juro.2017.04.086. Epub 2017 Apr 26. Erratum in: J Urol. 2017 Nov;198(5):1175. https:\/\/doi.org\/10.1016\/j.juro.2017.09.002. PMID: 28456635; PMCID: PMC5626446.","journal-title":"J Urol"},{"issue":"1","key":"19129_CR48","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.eururo.2008.07.018","volume":"55","author":"SM Donat","year":"2009","unstructured":"Donat SM, Shabsigh A, Savage C, Cronin AM, Bochner BH, Dalbagni G, Milowsky MI. Potential impact of postoperative early complications on the timing of adjuvant chemotherapy in patients undergoing radical cystectomy: a high-volume tertiary cancer center experience. Eur Urol. 2009;55(1):177\u201386.","journal-title":"Eur Urol"},{"issue":"2","key":"19129_CR49","first-page":"161","volume":"68","author":"CE Calderone","year":"2016","unstructured":"Calderone CE, Lerner SP, Taylor JM. The case for salvage cystectomy after pelvic radiation. Minerva Urol Nefrol. 2016;68(2):161\u201371.","journal-title":"Minerva Urol Nefrol"},{"issue":"2","key":"19129_CR50","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1111\/bju.14733","volume":"124","author":"N Ahmadi","year":"2019","unstructured":"Ahmadi N, Ashrafi AN, Hartman N, Shakir A, Cacciamani GE, Freitas D, Aron M. Use of indocyanine green to minimise uretero-enteric strictures after robotic radical cystectomy. BJU Int. 2019;124(2):302\u20137.","journal-title":"BJU Int"},{"issue":"6","key":"19129_CR51","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1111\/bju.16707","volume":"135","author":"CM Haney","year":"2025","unstructured":"Haney CM, Studier-Fischer A, Geissler ME, Ohlmeier J, Westhoff N, Stolzenburg JU, Kowalewski KF. Indocyanine-guided ureter resection for radical cystectomy\u2013a systematic review and meta-analysis. BJU Int. 2025;135(6):908\u201317.","journal-title":"BJU Int"},{"issue":"2","key":"19129_CR52","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/j.juro.2012.09.077","volume":"189","author":"DJ Parekh","year":"2013","unstructured":"Parekh DJ, Messer J, Fitzgerald J, Ercole B, Svatek R. Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. J Urol. 2013;189(2):474\u20139.","journal-title":"J Urol"},{"issue":"6","key":"19129_CR53","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1111\/bju.12818","volume":"114","author":"JC Messer","year":"2014","unstructured":"Messer JC, Punnen S, Fitzgerald J, Svatek R, Parekh DJ. Health-related quality of life from a prospective randomised clinical trial of robot-assisted laparoscopic vs open radical cystectomy. BJU Int. 2014;114(6):896\u2013902.","journal-title":"BJU Int"},{"issue":"2","key":"19129_CR54","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/j.eururo.2009.10.024","volume":"57","author":"J Nix","year":"2010","unstructured":"Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS. Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol. 2010;57(2):196\u2013201.","journal-title":"Eur Urol"},{"issue":"5_suppl","key":"19129_CR55","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1200\/JCO.2025.43.5_suppl.815","volume":"43","author":"P Ghatalia","year":"2025","unstructured":"Ghatalia P, Ross EA, Zibelman MR, Anari F, Abbosh P, Tester WJ, Geynisman DM. A phase 2 trial of risk enabled therapy after neoadjuvant chemo-immunotherapy for muscle-invasive bladder cancer (retain 2). J Clin Oncol. 2025;43(5_suppl):815\u2013815.","journal-title":"J Clin Oncol"},{"issue":"9","key":"19129_CR56","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1200\/JCO-24-01214","volume":"43","author":"DM Geynisman","year":"2025","unstructured":"Geynisman DM, Abbosh PH, Ross E, Zibelman MR, Ghatalia P, Anari F, Plimack ER. Phase II trial of risk-enabled therapy after neoadjuvant chemotherapy for muscle-invasive bladder cancer (RETAIN 1). J Clin Oncol. 2025;43(9):1113\u201322.","journal-title":"J Clin Oncol"},{"issue":"4","key":"19129_CR57","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1016\/j.euo.2025.05.019","volume":"8","author":"B Wang","year":"2025","unstructured":"Wang B, Davis LE, Weight CJ, Abouassaly R, Bukavina L. Real-world experience with a commercial circulating tumor DNA assay in non\u2013muscle-invasive bladder cancer. Eur Urol Oncol. 2025;8(4):883\u20137.","journal-title":"Eur Urol Oncol."},{"issue":"5","key":"19129_CR58","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.eururo.2025.03.023","volume":"88","author":"MP St-Laurent","year":"2025","unstructured":"St-Laurent MP, Singh P, McConkey DJ, Lucia MS, Koshkin VS, Stratton KL, Black PC. Urine tumor DNA to stratify the risk of recurrence in patients treated with atezolizumab for Bacillus Calmette-Gu\u00e9rin\u2013unresponsive non\u2013muscle-invasive Bladder Cancer. Eur Urol. 2025;88(5):430\u20134.","journal-title":"Eur Urol"},{"issue":"4","key":"19129_CR59","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.eururo.2025.05.035","volume":"88","author":"SS Chang","year":"2025","unstructured":"Chang SS, Launer B, Narayan V, Patil D, O\u2019Donnell MA, Hensley PJ, Daneshmand S. Computational histology artificial intelligence (CHAI) enhances risk stratification of high-grade Ta non-muscle-invasive bladder cancer in a multicenter cohort: comparison to current European Association of Urology and American Urological Association stratification schemes. Eur Urol. 2025;88(4):411\u20133.","journal-title":"Eur Urol"},{"issue":"1","key":"19129_CR60","doi-asserted-by":"publisher","first-page":"2214","DOI":"10.1038\/s41467-023-37696-2","volume":"14","author":"M Minoli","year":"2023","unstructured":"Minoli M, Cantore T, Hanhart D, Kiener M, Fedrizzi T, La Manna F, Kruithof-de Julio M. Bladder cancer organoids as a functional system to model different disease stages and therapy response. Nat Commun. 2023;14(1):2214.","journal-title":"Nat Commun"},{"issue":"6","key":"19129_CR61","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1016\/S1470-2045(24)00178-5","volume":"25","author":"A Necchi","year":"2024","unstructured":"Necchi A, Roumigui\u00e9 M, Kamat AM, Shore ND, Boormans JL, Esen AA, Kulkarni GS. Pembrolizumab monotherapy for high-risk non-muscle-invasive bladder cancer without carcinoma in situ and unresponsive to BCG (KEYNOTE-057): a single-arm, multicentre, phase 2 trial. Lancet Oncol. 2024;25(6):720\u201330.","journal-title":"Lancet Oncol"},{"issue":"7","key":"19129_CR62","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1016\/S1470-2045(21)00147-9","volume":"22","author":"AV Balar","year":"2021","unstructured":"Balar AV, Kamat AM, Kulkarni GS, Uchio EM, Boormans JL, Roumigui\u00e9 M, de Wit R. Pembrolizumab monotherapy for the treatment of high-risk non-muscle-invasive bladder cancer unresponsive to BCG (KEYNOTE-057): an open-label, single-arm, multicentre, phase 2 study. Lancet Oncol. 2021;22(7):919\u201330.","journal-title":"Lancet Oncol"},{"issue":"1","key":"19129_CR63","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/S1470-2045(20)30540-4","volume":"22","author":"SA Boorjian","year":"2021","unstructured":"Boorjian SA, Alemozaffar M, Konety BR, Shore ND, Gomella LG, Kamat AM, Dinney CP. Intravesical nadofaragene firadenovec gene therapy for BCG-unresponsive non-muscle-invasive bladder cancer: a single-arm, open-label, repeat-dose clinical trial. Lancet Oncol. 2021;22(1):107\u201317.","journal-title":"Lancet Oncol"},{"issue":"1","key":"19129_CR64","first-page":"EVIDoa2200167","volume":"2","author":"K Chamie","year":"2022","unstructured":"Chamie K, Chang SS, Kramolowsky E, Gonzalgo ML, Agarwal PK, Bassett JC, Soon-Shiong P. IL-15 superagonist NAI in BCG-unresponsive non\u2013muscle-invasive bladder cancer. NEJM Evidence. 2022;2(1):EVIDoa2200167.","journal-title":"NEJM Evidence"},{"issue":"33","key":"19129_CR65","doi-asserted-by":"publisher","first-page":"3578","DOI":"10.1200\/JCO-25-01651","volume":"43","author":"S Daneshmand","year":"2025","unstructured":"Daneshmand S, Van der Heijden MS, Jacob JM, Guerrero-Ramos F, B\u00f6gemann M, Simone G, Necchi A. TAR-200 for Bacillus Calmette-Gu\u00e9rin\u2013unresponsive high-risk non\u2013muscle-invasive bladder cancer: results from the phase IIb sunRISe-1 study. J Clin Oncol. 2025;43(33):3578\u201388.","journal-title":"J Clin Oncol"},{"key":"19129_CR66","unstructured":"Tyson M, Uchio E, Nam J. First results from BOND-003: phase 3 study of cretostimogene grenadenorepvec monotherapy for patients with BCG unresponsive high-risk NMIBC with CIS+\/\u2212papillary (Ta\/T1) tumors. In: 24th Annual Meeting of the Society of Urologic Oncology. 2023."}],"container-title":["Annals of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-026-19129-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1245\/s10434-026-19129-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-026-19129-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:02:12Z","timestamp":1776258132000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1245\/s10434-026-19129-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":66,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["19129"],"URL":"https:\/\/doi.org\/10.1245\/s10434-026-19129-8","relation":{},"ISSN":["1068-9265","1534-4681"],"issn-type":[{"value":"1068-9265","type":"print"},{"value":"1534-4681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]},"assertion":[{"value":"16 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflicts of interest. During manuscript preparation, the LLM tool OpenAI ChatGPT 5.1 was used to improve readability and refine spelling and grammar. The authors take full responsibility for the scientific content.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}