This from Dr. Steinberg a leading blc specialist
"Radical cystectomy
Although typically reserved for muscle-invasive disease, radical surgery is more appropriately used to treat some cases of non–muscle-invasive bladder cancer.
Thirty-five to fifty percent of patients who undergo cystectomy for Ta, T1, or CIS are discovered to have muscle-invasive disease, with 10-15% demonstrating microscopic lymph node metastasis.
The CIS in upwards of 80% of affected patients progresses to muscle-invasive disease, with 20% of patients found to have muscle-invasive disease at the time of cystectomy.
High-grade T1 tumors that recur despite BCG have a 50% likelihood of progressing to muscle-invasive disease. Cystectomy performed prior to progression yields a 90% 5-year survival rate. The 5-year survival rate drops to 50-60% in muscle-invasive disease.
Patients with unresectable large superficial tumors, prostatic urethra involvement, and BCG failure should also undergo radical cystectomy.
Pat