Cystectomy/adverse effects/*methods Disease-Free Survival Follow-Up Studies Humans Incidence Intraoperative Complications/*epidemiology/etiology Length of Stay/statistics & numerical data Neoplasm Recurrence Local/*epidemiology/etiology/prevention & control Randomized Controlled Trials as Topic Urinary Bladder/*injuries/pathology/surgery Urinary Bladder Neoplasms/mortality/pathology/*surgery Bipolar bladder tumors meta-analysis monopolar transurethral resection

Adjuvants Immunologic/administration & dosage Administration Intravesical Antibiotics Antineoplastic/administration & dosage/adverse effects Antimetabolites Antineoplastic/*administration & dosage/adverse effects BCG Vaccine/administration & dosage Bias Cause of Death Confidence Intervals Deoxycytidine/administration & dosage/adverse effects/*analogs & derivatives Disease Progression Drug Administration Schedule Humans Mitomycin/administration & dosage/adverse effects Neoplasm Recurrence Local/*drug therapy/mortality/prevention & control Randomized Controlled Trials as Topic Saline Solution/administration & dosage Urinary Bladder Neoplasms/*drug therapy/mortality/pathology/prevention & control Gemcitabine

Aged Cystectomy/adverse effects/*methods/statistics & numerical data Humans Male Middle Aged Postoperative Complications Quality of Life Randomized Controlled Trials as Topic Robotic Surgical Procedures/adverse effects/*methods/statistics & numerical data Treatment Outcome Urinary Bladder Neoplasms/*surgery

Anti-Bacterial Agents/therapeutic use Antibiotic Prophylaxis Humans Meta-Analysis as Topic Postoperative Complications/drug therapy Systematic Reviews as Topic *Urinary Bladder Neoplasms/drug therapy/surgery *Urinary Tract Infections/drug therapy/prevention & control Antibiotic resistance Antibiotics Antimicrobial stewardship Bacteriuria Endourological surgery Guideline Recommendation Transitional cell carcinoma Urothelium cell carcinoma

Administration Intravesical Antibiotics Antineoplastic/*administration & dosage Antimetabolites Antineoplastic/*administration & dosage Deoxycytidine/administration & dosage/*analogs & derivatives Humans Mitomycin/*administration & dosage Neoplasm Invasiveness Randomized Controlled Trials as Topic Urinary Bladder Neoplasms/*drug therapy/pathology Gemcitabine Bladder cancer Meta-analysis Mitomycin Systematic evaluation

Administration Intravesical Antibiotics Antineoplastic/administration & dosage/*therapeutic use BCG Vaccine Carcinoma Transitional Cell/*drug therapy Humans Mitomycin/administration & dosage/*therapeutic use Randomized Controlled Trials as Topic Treatment Outcome Urinary Bladder Neoplasms/*drug therapy

Asia Asian People Humans *MicroRNAs/genetics *Urinary Bladder Neoplasms/diagnosis/genetics

Antineoplastic Combined Chemotherapy Protocols/*therapeutic use Carcinoma Transitional Cell/immunology/mortality/pathology/*therapy Chemotherapy Adjuvant/methods/statistics & numerical data Clinical Trials Phase I as Topic Clinical Trials Phase II as Topic Cystectomy Disease-Free Survival Follow-Up Studies Humans Immune Checkpoint Inhibitors/*therapeutic use Muscle Smooth/pathology/surgery Neoadjuvant Therapy/*methods/statistics & numerical data Neoplasm Invasiveness/pathology Prospective Studies Treatment Outcome Urinary Bladder/pathology/surgery Urinary Bladder Neoplasms/immunology/mortality/pathology/*therapy Bladder cancer Immune checkpoint inhibitors Immunotherapy Neoadjuvant

Cystectomy/adverse effects Humans Postoperative Complications/diagnosis/epidemiology/etiology Risk Factors *Robotic Surgical Procedures/adverse effects *Robotics Treatment Outcome *Urinary Bladder Neoplasms/surgery Urologic Surgical Procedures *Urology Complications European Association of Urology guidelines Outcome reporting Robot-assisted radical cystectomy Standardised tool

Humans Incidence Risk Factors Suicide/*statistics & numerical data Urinary Bladder Neoplasms/diagnosis/*psychology Bladder cancer Meta-analysis Suicide Systematic review

bladder cancer mediation socioeconomic status survival systematic review Janssen and undertakes research funded by UroGen Pharma and QED Therapeutics. We can confirm all other authors have no conflicts of interest to declare.

Adult Aged Aged 80 and over B7-H1 Antigen/genetics/*immunology Female Humans Immune Checkpoint Inhibitors/*administration & dosage *Immunotherapy Male Middle Aged Programmed Cell Death 1 Receptor/genetics/*immunology Progression-Free Survival Randomized Controlled Trials as Topic Treatment Outcome Urinary Bladder Neoplasms/genetics/immunology/mortality/*therapy efficacy immunotherapy meta-analysis safety urothelial cancer this study.

Guidelines as Topic Humans Immunotherapy/*methods Societies Medical/*standards Urinary Bladder Neoplasms/*drug therapy antineoplastic protocols immunotherapy urinary bladder neoplasms urologic neoplasms Pfizer AstraZeneca Nektar Seattle Genetics DragonFly Therapeutics Non-CME services: Genentech AstraZeneca Merck Seattle Genetics Contracted research: Genentech Merck AstraZeneca Nektar Seattle Genetics Immunomedics. PCB─Consulting fees: AbbVie Asieris Pharmaceuticals Astellas AstraZeneca Bayer Biosyent Bristol-Myers Squibb EMD Serono Ferring Fergene H3 Biomedicine Janssen Merck Roche Sanofi TerSera Urogen Contracted research: iProgen. MTC─Consulting fees: Pfizer EMD Serono AstraZeneca Exelixis Eisai Seattle Genetics Astellas Contracted research: Exelixis Pfizer/EMD Serono Janssen Apricity Health. GSD─Participant/unpaid volunteer: HealthVibe focus group 2020. MDG─Consulting fees: Inovio NuMab Janssen Merck GlaxoSmithKline Genentech Bristol-Myers Squibb Seattle Genetics Dracen Dragonfly Astellas Novartis Pfizer AstraZeneca Incyte Dendreon Eli Lilly EMD Serono Aileron Therapeutics Ownership interest: Rappta Therapeutics NPI: 1639140668. PG─Consulting fees: AstraZeneca Dyania Health EMD Serono Immunomedics Janssen Merck Mirati Therapeutics Genentech Pfizer Seattle Genetics Contracted Research: Bavarian Nordic Bristol-Myers Squibb Clovis Oncology Debiopharm Immunomedics Pfizer Merck QED Therapeutics GlaxoSmithKline Kure It Cancer Research Mirati Therapeutics. SG─Consulting fees: Merck Bristol-Myers Squibb Janssen Seattle Genetics AstraZeneca Contracted research: Bristol-Myers Squibb Pfizer Non-CME services: Exelixis. CJH─Consulting fees: Astellas Bristol-Myers Squibb Genentech Merck Eisai Seattle Genetics 2bPrecise Non-CME services: Astellas Bristol-Myers Squibb Genentech Eisai Seattle Genetics. AMK─Consulting fees: Abbott Molecular Arquer ArTara Asieris AstraZeneca BioClin Therapeutics Bristol-Myers Squibb Cepheid Cold Genesys Eisai Engene Inc. Ferring FerGene Imagin Janssen MDxHealth Medac Merck Pfizer Photocure ProTara Roviant Seattle Genetics Sessen Bio Theralase TMC Innovation US Biotest Contracted research: Adolor Bristol-Myers Squibb FKD Industries Heat Biologics Merck Photocure SWOG/NIH SPORE AIBCCR Clinical trials: FKD Merck Bristol-Myers Squibb Photocure SWOG Adolor Heat Biologics Laboratory research: NIH SPORE AIBCCR Educational grant: CEC Oncology Editorial board: European Urology Oncology Journal of Urology UroToday President of organization: International Bladder Cancer Network (IBCN) International Bladder Cancer Group (IBCG) IP Rights: CyPRIT (Cytokine Predictors of Response to Intravesical Therapy) Joint with UT MD Anderson Cancer Center. LPL─Consulting fees: Pfizer Advisory Nursing board 2018 Lecture/Speaker/Expert Panel: ASCO Bladder Program 2019 Pfizer learning day 2019 ASCO Bladder Program Panel Member and Faculty 2019 Pfizer Learning Day Speaker 2019 BCAN Webinar Faculty 11/2020. JJM─Consulting fees: AstraZeneca Ferring Janssen Nucleix Foundation Medicine Contracted research: Epizyme Tesaro Abbvie Teaching an endoscopy course: Olympus. ERP─Consulting fees: AstraZeneca Infinity Pharma Pfizer Flatiron Genentech Merck Seattle Genetics Contracted research: Astellas Bristol-Myers Squibb Genentech Merck. JER─Consulting fees: Merck Bristol-Myers Squibb AstraZeneca Astellas Seattle Genetics Boehringer Ingelheim Bayer Pfizer Roche/Genentech Mirati QED Therapeutics Janssen Pharmacyclics GlaxoSmithKline Contracted research/Clinical trial funding: Seattle Genetics Astellas Roche/Genentech Bayer AstraZeneca QED Therapeutics. NS─Consulting fees: Amgen Astellas AstraZeneca Bayer Bristol-Myers Squibb Dendreon Fergene Ferring Janssen Merck Myovant Nymox Pfizer Sanofi/Genzyme Sesen Bio Sun Pharma Tolmar. GDS─Consulting fees: Merck Janssen Ferring Bristol-Myers Squibb Pfizer Genentech Epivax Oncology AstraZeneca Fidia Cold Genesys EnGene Bio Aduro Biotech Dendreon FKD Therapies CiClomed Seattle Genetics Urogen PhotoCure. SITC staff: SMW—Shares owned: Pacific Biosciences Editas Medicine EG AK BL LL─Nothing to disclose.

Antineoplastic Agents/*therapeutic use Chemotherapy Adjuvant/*statistics & numerical data *Cystectomy Global Health Guideline Adherence/statistics & numerical data Humans Models Statistical Neoadjuvant Therapy/*statistics & numerical data Neoplasm Invasiveness Practice Guidelines as Topic Practice Patterns Physicians'/*statistics & numerical data Urinary Bladder Neoplasms/*drug therapy/pathology/surgery

Biomarkers Tumor/*urine DNA Neoplasm/*urine Humans RNA Neoplasm/*urine Urinary Bladder Neoplasms/*genetics/*urine Watchful Waiting Biomarkers Bladder Genetic Surveillance

5-ala 5-aminolaevulinic acid Hal Pdd accuracy meta-analysis bladder cancer blue light cystoscopy cystoscopy hexaminolevulinate narrow band imaging photodynamic diagnosis fluorescence consultant for Janssen Ferring Photocure Taris Spectrum Pacific Edge QED Abbvie Johnson & Johnson Seattle Genetics Nucleix Aduro and BMS. Ashish Kamat is is a consultant for Photocure. Mihir Desai is a consultant for Procept Biorobotics and Auris Surgical. Yair Lotan is a consultant for Photocure. Angela Smith is an investigator for Urogen and a consultant for FerGene Urogen and Merck.

Biomarkers Tumor/genetics Carcinoma/genetics Gene Expression/genetics Gene Expression Profiling/methods Gene Expression Regulation Neoplastic/genetics Humans Neoplasm Recurrence Local/genetics Odds Ratio Prognosis RNA Circular/*genetics Survival Analysis Transcriptome/genetics Urinary Bladder/pathology Urinary Bladder Neoplasms/*genetics/metabolism bladder cancer circular RNA meta-analysis

Blood Loss Surgical/statistics & numerical data Cystectomy/*methods Humans Length of Stay/statistics & numerical data Lymph Node Excision *Minimally Invasive Surgical Procedures Operative Time Postoperative Complications/epidemiology Randomized Controlled Trials as Topic Urinary Bladder Neoplasms/*surgery Bladder cancer Meta-analysis Minimally invasive Open radical cystectomy Randomized controlled trials

Case-Control Studies Humans *Polymorphism Single Nucleotide Promoter Regions Genetic Urinary Bladder Neoplasms/*genetics Vascular Endothelial Growth Factor A/*genetics Bladder cancer Meta-analysis Polymorphism Vascular endothelial growth factor competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Cystectomy/adverse effects/*methods Humans *Robotic Surgical Procedures Treatment Outcome Urinary Bladder Neoplasms/*surgery Bladder cancer Cystectomy Meta-analysis Minimally invasive Robotics