Level 1 evidence supports neoadjuvant chemotherapy followed by a radical cystectomy (RC) for treating muscle-invasive bladder cancer (MIBC).¹ Given its substantial perioperative morbidity, bladder preservation therapy (BPT) is an alternative treatment option for individuals who wish to avoid or are not able to undergo RC.² Given the absence of prospective randomized clinical trials, well-designed observational cohort studies currently offer the best comparative effectiveness evidence to evaluate these treatment options.

中文翻译：

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膀胱切除术与保留疗法的争论

1级证据支持新辅助化疗，然后行根治性膀胱切除术（RC）治疗肌肉浸润性膀胱癌（MIBC）。¹鉴于其围手术期的高发病率，对于希望避免或无法进行RC的个体，膀胱保留疗法（BPT）是一种替代治疗选择。²由于缺乏前瞻性随机临床试验，设计良好的观察性队列研究目前提供最佳的比较有效性证据，以评估这些治疗方案。