Is it appropriate to offer definitive trimodality therapy, as an equivalent option to neoadjuvant chemotherapy followed by radical cystectomy, in patients with muscle-invasive bladder cancer regardless of fitness or platinum eligibility?  

There are now several retrospective studies utilizing advanced statistical techniques suggesting that outcomes after trimodality therapy (TMT) are very similar to those after surgery (e.g., Zlotta et al., PMID 37187202, Brück et al., PMID 37517601, and Kulkarni et al., PMID 28410011). These fin...