For a young patient with small cell bladder cancer, what would you recommend following cisplatin + etoposide, if scans show no evidence of distant disease and repeat TURBT shows no malignancy?   

We would proceed with locoregional definitive therapy with either radical cystectomy & PLND or (chemo)radiation. Would not rely on TURBT alone. Limited datasets from MDACC slightly favor radical cystectomy but there is no high level evidence comparing surgical vs (chemo)radiation consolidation s...

Agree with @Petros Grivas. A fraction of these patients can be cured, and therefore local definitive therapy should be encouraged. Multiple retrospective studies have compared cystectomy vs chemoradiation in patients with localized disease, and outcomes do not appear to differ significantly. In the ...