{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:58:36Z","timestamp":1790675916594,"version":"4.1.0"},"reference-count":24,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SJU"],"abstract":"<jats:p>Objective: The Gold standard treatment for muscle-invasive bladder cancer (MIBC) in medically fit patients is neoadjuvant chemotherapy (NAC), followed by radical cystectomy (RC), usually urethra-sparing. Swedish guidelines recommend yearly urethroscopies for 5 years post-RC to detect urethral recurrences (URs). Evidence is limited regarding optimal urethral surveillance in the NAC-era for patients with MIBC. The goal was to evaluate UR-frequency across NAC-response groups: complete response (CR), i.e. pT0N0M0, and Non-CR-responses (partial response, stable disease, and progressive disease), compared with cystectomy-only controls.\nMaterials and methods: A multicenter retrospective cohort study including 241 patients with \u2265T2 disease in clinical and\/or pathological staging (post-RC), urothelial or mixed urothelial histology, and undergoing urethra-sparing cystectomy between 2010 and 2024. Data were retrieved from medical records and transferred into an ethically approved database. UR was biopsy-confirmed; time to UR was analyzed using Aalen\u2013Johansen cumulative incidence functions with the Gray\u2019s test.\nResults: 40% (50\/123) of the NAC-patients were complete responders. Nine UR-events occurred (3.7%) in the total material. UR was observed in 3\/123 (2.4%) NAC-treated and 6\/118 (5.1%) in No-NAC patients (Gray\u2019s, p = 0.291). No UR occurred among complete responders to NAC (0\/50) versus 3\/73 in non-complete responders (Gray\u2019s, p = 0.150). Four UR-cases (44.4%) were symptom-detected (urethral bleeding).\nConclusions: The total absence of urethral recurrences in NAC- and RC-treated MIBC-patients with complete responses suggests that the current Swedish recommendation of yearly urethroscopies could be reviewed since a more individualized surveillance strategy based on NAC-response may reduce unnecessary procedures.<\/jats:p>","DOI":"10.2340\/sju.v61.46892","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:22:19Z","timestamp":1790673739000},"page":"230-238","source":"Crossref","is-referenced-by-count":0,"title":["No urethral recurrences in complete responders after neoadjuvant chemotherapy and cystectomy for muscle-invasive bladder cancer"],"prefix":"10.2340","volume":"61","author":[{"given":"Sofia","family":"Lingefelt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Nystrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3589-7789","authenticated-orcid":false,"given":"Farhood","family":"Alamdari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8601-0159","authenticated-orcid":false,"given":"Johan","family":"Svensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3675-3050","authenticated-orcid":false,"given":"Amir","family":"Sherif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"169554","unstructured":"EAU guidelines on muscle-invasive and metastatic bladder cancer \u2013 Uroweb [Internet]. 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[cited 2026 May 5]. Available from: https:\/\/kunskapsbanken.cancercentrum.se\/diagnoser\/urinblase-och-urinvagscancer\/vardprogram\/primar-behandling\/"},{"key":"169559","doi-asserted-by":"crossref","unstructured":"Rydell H, Ericson A, Eriksson V, et al. Thromboembolic events in patients undergoing neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: a study of renal impairment in relation to potential thromboprophylaxis. J Pers Med. 2022;12(12):1961.","DOI":"10.3390\/jpm12121961"},{"key":"169560","doi-asserted-by":"crossref","unstructured":"Gopalakrishnan D, Elsayed AS, Hussein AA, et al. Impact of neoadjuvant chemotherapy on survival and recurrence patterns after robot-assisted radical cystectomy for muscle-invasive bladder cancer: results from the International Robotic Cystectomy Consortium. 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Urol Oncol. 2018;36(2):54\u201359.","DOI":"10.1016\/j.urolonc.2017.11.007"},{"key":"169564","doi-asserted-by":"crossref","unstructured":"Boorjian SA, Kim SP, Weight CJ, et al. Risk factors and outcomes of urethral recurrence following radical cystectomy. Eur Urol. 2011;60(6):1266\u20131272.","DOI":"10.1016\/j.eururo.2011.08.030"},{"key":"169565","doi-asserted-by":"crossref","unstructured":"Li X, Wang W, Zhu G, et al. Risk factors, follow-up, and treatment of urethral recurrence following radical cystectomy and urinary diversion for bladder cancer: a meta-analysis of 9498 patients. Oncotarget. 2018;9(2):2782\u20132796.","DOI":"10.18632\/oncotarget.23451"},{"key":"169566","doi-asserted-by":"crossref","unstructured":"Boorjian SA, Tollefson MK, Cheville JC, et al. Detection of asymptomatic recurrence during routine oncological followup after radical cystectomy is associated with improved patient survival. 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