Is it appropriate to re-consider bladder preservation in patients with bladder muscle-invasive cancer (T2) who were initially poor candidates for BP (multifocal disease, etc.) but had complete response after neoadjuvant chemotherapy?

It is perfectly appropriate. There are many ways to achieve a complete response to T2 bladder cancer. It can be reached with radiation, an aggressive local resection, or chemotherapy. The issue is whether or not it is durable. None of these therapies alone have a great track record, although chemoth...

It's reasonable to treat the patient with definitive radiation after chemotherapy. Neoadjuvant therapy followed by definitive local therapy (either radiation or surgery) was studied in this trial and showed that patients benefited from the chemotherapy. The major caveat of this trial is that the loc...