Antibodies Monoclonal Humanized/*therapeutic use *Carcinoma Transitional Cell/drug therapy Humans Prognosis Retrospective Studies *Urinary Bladder Neoplasms/drug therapy Metastatic urothelial carcinoma Pembrolizumab Prognostic factor Janssen and Pfizer. Takahiro Kimura is a paid consultant/advisor of Astellas Bayer Janssen and Sanofi. Shahrokh F. Shariat is a paid as follows: Honoraria: Astellas AstraZeneca Bayer BMS Cepheid Ferring Ipsen Janssen Lilly MSD Olympus Pfizer Pierre Fabre Richard Wolf Roche Sanochemia Sanofi Takeda Urogen. Consulting or Advisory Role: Astellas AstraZeneca Bayer BMS Cepheid Ferring Ipsen Janssen Lilly MSD Olympus Pfizer Pierre Fabre Richard Wolf Roche Sanochemia Sanofi Takeda Urogen. Speakers Bureau: Astellas Astra Zeneca Bayer BMS Cepheid Ferring Ipsen Janssen Lilly MSD Olympus Pfizer Pierre Fabre Richard Wolf Roche Sanochemia Sanofi Takeda Urogen Movember Foundation. The other authors declare no conflicts of interest associated with this manuscript.

Antineoplastic Combined Chemotherapy Protocols/therapeutic use *Carcinoma Transitional Cell/pathology Cisplatin/therapeutic use Cystectomy Humans Muscles/pathology Neoadjuvant Therapy Neoplasm Invasiveness *Urinary Bladder Neoplasms/pathology Bladder cancer Muscle-invasive Urothelial from MSD and BMS and Speaker and Other from AstraZecena. BPV reports Advisory Board Speaker and Other from Astellas Roche BMS and Merk-Pfizer Advisory Board and Other from Ipsen Advisory Board and Speaker from EUSA and MSD and Advisory Board from Sanofi. IPF report Advisory Board Speaker and Other from Pfizer Speaker and Other from Ipsen and Roche Advisory Board from EUSA and BMS and Speaker from Novartis and MSD. OFC reports Advisory Board and Speaker from Ipsen and Astellas Advisory Board from BMS and Pfizer-Merck and Speaker from AstraZeneca. AGA has received research funding from Astellas travel grants from Astellas Jansen Sanofi BMS Roche Pfizer and Ipsen and honoraria for speaker engagements advisory boards and continuous medical education from Janssen Astellas Sanofi Bayer Roche Ipsen BMS MSD Pfizer Eusa Pharma Eisai and AstraZeneca. JAA reports honoraria from Astellas Pfizer and BMS conulting or advisory role from Pfizer Astellas Janssen-Cilag MSD Oncology BMS Merck AstraZeneca Bayer and Eisai and Research Funding from BMS. RMB SVE CCD and MDS have nothing to disclose.

Cystectomy Humans Procedures and Techniques Utilization/*statistics & numerical data Prospective Studies Retrospective Studies Risk Assessment Urinary Bladder Neoplasms/*surgery Predictors Radical cystectomy Use Utilization interest including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg employment/affiliation grants or funding consultancies honoraria stock ownership or options expert testimony royalties or patents filed received or pending) are the following: None.

Carcinoma Transitional Cell/epidemiology/*surgery *Cystectomy Humans Kidney Neoplasms/*epidemiology Neoplasms Second Primary/*epidemiology Ureteral Neoplasms/*epidemiology Urethral Neoplasms/*epidemiology Urinary Bladder Neoplasms/*surgery Bladder cancer Radical cystectomy Recurrence Remnant Upper urinary tract Urethra Urothelium including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg employment/affiliation grants or funding consultancies honoraria stock ownership or options expert testimony royalties or patents filed received or pending) are the following: None.

Clinical Decision-Making Cystectomy/*methods Cytoreduction Surgical Procedures/methods Humans *Neoplasm Metastasis/pathology/therapy Practice Guidelines as Topic Treatment Outcome *Urinary Bladder Neoplasms/pathology/surgery Bladder cancer Lymph node dissection Lymph node metastasis Metastasectomy Metastatic bladder cancer Surgery interest including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg employment/affiliation grants or funding consultancies honoraria stock ownership or options expert testimony royalties or patents filed received or pending) are the following: None.

Critical Pathways Cystectomy/*methods/rehabilitation Humans Length of Stay Postoperative Care/*methods Postoperative Complications/*epidemiology *Standard of Care Urinary Bladder Neoplasms/*surgery Urinary Diversion/*methods/rehabilitation Clinical pathways Collaborative care Cystectomy Enhanced recovery Fast track including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg employment/affiliation grants or funding consultancies honoraria stock ownership or options expert testimony royalties or patents filed received or pending) are the following: None.

Kaplan-Meier Estimate Neoplasm Grading Neoplasm Metastasis Neoplasm Staging Odds Ratio Prognosis Publication Bias Urinary Bladder Neoplasms/*mortality/*pathology/therapy histological variants squamous differentiation urothelial carcinoma of the bladder including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg employment/affiliation grants or funding consultancies honoraria stock ownership or options expert testimony royalties or patents filed received or pending) are the following: None.