Editing Muscle-Invasive Bladder Cancer (section)

==== Prognosis ====
* Despite aggressive surgical therapy, ≈50% of cystectomy patients will ultimately die of disease
* '''Most recurrences will occur within the 2-3 years after cystectomy'''
* '''<span style="color:#ff0000">Prognostic factors following RC</span>'''
*# '''<span style="color:#ff0000">pT stage and presence of nodal metastasis (strongest predictors of recurrence and survival following cystectomy)</span>'''
*# '''<span style="color:#ff0000">Margin status</span>'''
*# '''<span style="color:#ff0000">Presence of lymphovascular invasion</span>'''
*#* In MIBC, presence of LVI is associated with features of aggressive disease and predicts recurrence and survival§
*#* Recall, LVI associated with progression in high-risk NMIBC
*# '''Presence of hydronephrosis'''
*#'''Molecular markers'''
*#'''Variant histology'''
*# Body mass index
*# Age
*# Gender
*# Surgical expertise
*# Hospital volume
*# Time from initial diagnosis of muscle invasion to cystectomy (particularly if there is a delay >12 weeks)
*Systemic recurrence rates by stage:
**pT2: 20-30%
**pT3: 40%
**pT4>50%
**N+: 70%
* The [https://pubmed.ncbi.nlm.nih.gov/17121885/ Bladder Cancer Research Consortium] and [https://www.mskcc.org/nomograms/bladder/post_op The International Bladder Cancer Consortium] have developed nomograms to predict recurrence following radical cystectomy
* Currently, most patients with recurrence after cystectomy are not cured with current systemic therapies
**