“…7 The debate is whether this therapy can achieve the same survival rates that are obtained with radical cystectomy; however, because of the lack of long-term randomized studies, this comparison is still unknown. 1,4,7 When the bladder is to be preserved, the treatment of invasive tumor is performed with Trimodal Therapy (TMT), which determines a surgical approach with radical TUR, radiotherapy and chemotherapy, selecting well the patients who should undergo this therapeutic line for a correct comparative study with the other therapies. 3,4,6,7,8 Patients with tumor-related hydronephrosis, flat lesions such as CIS, locally advanced disease (T4), presence of urethral obstruction and lymph node involvement are poor candidates for preservation of the bladder and are generally excluded from TMT.…”