Female *Health Status Humans Male Middle Aged *Quality of Life Surveys and Questionnaires Treatment Outcome Urinary Bladder/*surgery Urinary Bladder Neoplasms/*surgery Urinary Diversion/*methods Urinary Reservoirs Continent Bladder cancer Meta-analysis Quality of life Urinary diversion

Cystectomy/*methods Humans *Robotic Surgical Procedures Treatment Outcome Urinary Bladder Neoplasms/*surgery Oncologic outcome Open radical cystectomy Positive surgical margin Robot-assisted radical cystectomy

Blood Loss Surgical *Cystectomy Diet Humans Lymph Nodes/pathology *Minimally Invasive Surgical Procedures Postoperative Complications/etiology Randomized Controlled Trials as Topic Recurrence Treatment Outcome Urinary Bladder Neoplasms/*surgery Open radical cystectomy laparoscopic radical cystectomy meta-analysis minimally invasive randomized controlled trials robot-assisted radical cystectomy

*Conversion to Open Surgery *Cystectomy Humans Odds Ratio Operative Time Postoperative Complications/etiology *Robotic Surgical Procedures Treatment Outcome Urinary Bladder Neoplasms/*surgery complications meta-analysis open radical cystectomy robotic

Administration Intravesical Antineoplastic Agents/*pharmacology Humans Maintenance Chemotherapy/*methods Neoplasm Invasiveness Neoplasm Recurrence Local/*prevention & control Prognosis Randomized Controlled Trials as Topic Treatment Outcome *Urinary Bladder Neoplasms/drug therapy/pathology Bladder cancer Chemotherapy Intravesical Maintenance

Administration Intravesical Aged Aged 80 and over BCG Vaccine/*therapeutic use Biopsy Needle Disease-Free Survival Female Humans Immunohistochemistry Immunotherapy/*methods In Situ Hybridization Fluorescence Male Middle Aged Neoplasm Recurrence Local/mortality/*pathology Predictive Value of Tests Prognosis Risk Assessment Survival Analysis Treatment Outcome Urinary Bladder Neoplasms/mortality/pathology/*therapy Bcg Bladder cancer Immunotherapy Personalized therapy Response prediction

Chemoradiotherapy Adjuvant Combined Modality Therapy Cystectomy/*methods Disease-Free Survival Humans Muscles/pathology Neoadjuvant Therapy Neoplasm Invasiveness Treatment Outcome Urinary Bladder Neoplasms/pathology/*therapy Bladder cancer Radical cystectomy Trimodal therapy

Antineoplastic Agents/*therapeutic use Carcinoma Transitional Cell/pathology/*therapy Chemotherapy Adjuvant Cystectomy Cystoscopy Humans Lymph Node Excision Muscle Smooth/*pathology *Neoadjuvant Therapy Neoplasm Invasiveness *Organ Sparing Treatments Progression-Free Survival Proportional Hazards Models *Radiotherapy Adjuvant Survival Rate Urinary Bladder Neoplasms/pathology/*therapy Bladder preserving Cancer Muscle invasive Radical cystectomy Trimodal

Chemoradiotherapy/*methods Combined Modality Therapy Cystectomy/*adverse effects/methods Disease-Free Survival Female Humans Male Middle Aged Neoplasm Metastasis Robotic Surgical Procedures/*adverse effects/methods Treatment Outcome Urinary Bladder Neoplasms/diagnostic imaging/*therapy Bladder cancer Cystectomy Multi-modality treatment Port-site metastasis Rare complications

Aged Aged 80 and over Chemoradiotherapy/*mortality/*statistics & numerical data Combined Modality Therapy Cystectomy/*mortality/*statistics & numerical data Disease-Free Survival Female Humans Male Middle Aged Neoplasm Invasiveness Postoperative Complications/mortality/prevention & control Prevalence Radiation Injuries/mortality/prevention & control Risk Factors Survival Rate Treatment Outcome Urinary Bladder Neoplasms/*mortality/*therapy

Cystectomy/*methods Humans Length of Stay Operative Time Postoperative Complications Robotic Surgical Procedures/*methods Treatment Outcome Urinary Bladder Neoplasms/*surgery bladder cancer cystectomy robotics

Cystectomy/*methods Female Humans Organ Sparing Treatments/*methods Postoperative Complications Sexual Dysfunction Physiological/*prevention & control Treatment Outcome Urinary Bladder/*pathology Urinary Bladder Neoplasms/physiopathology/*surgery Urinary Diversion/*methods Urinary Incontinence/*prevention & control #BladderCancer #blcsm radical cystectomy sexual function urinary bladder neoplasms urinary incontinence

*Adaptation Psychological Humans Quality of Life Survivors/*psychology Urinary Bladder Neoplasms/mortality/pathology/*psychology Bladder cancer Cystectomy Diagnosis Patients’ experience Treatment FUNDING: This work was funded by Yorkshire Cancer Research (grant number S388).

Adjuvants Immunologic/*administration & dosage/adverse effects Administration Intravesical Antineoplastic Agents/*administration & dosage/adverse effects BCG Vaccine Carcinoma in Situ/mortality/pathology/*therapy Combined Modality Therapy/adverse effects/methods Disease Progression Drug Administration Schedule Humans Interferon-alpha/*administration & dosage/adverse effects Neoplasm Recurrence Local Randomized Controlled Trials as Topic Time Factors Urinary Bladder Neoplasms/mortality/pathology/*therapy Withholding Treatment/statistics & numerical data

Administration Intravesical Antineoplastic Agents/*administration & dosage/adverse effects Asymptomatic Diseases BCG Vaccine/*administration & dosage/adverse effects Bacteriuria/*complications/diagnosis Humans Immunotherapy/adverse effects/*methods Neoplasm Invasiveness Risk Assessment Treatment Outcome Urinary Bladder Neoplasms/complications/*drug therapy/immunology/pathology Bacillus Calmette-Guerin Bacteriuria Bladder cancer Intravesical instillation

Anemia/*complications Cystectomy/*methods Female Humans Male Preoperative Period Proportional Hazards Models Survival Analysis Treatment Outcome Urinary Bladder Neoplasms/*surgery Anemia Bladder cancer Hemoglobin Mortality Recurrence

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.

Aged Catheterization Chemotherapy Adjuvant Feasibility Studies Female Humans *Laser Therapy Length of Stay Male Middle Aged Operative Time Postoperative Complications/etiology Time Factors Treatment Outcome Urinary Bladder Neoplasms/drug therapy/pathology/*radiotherapy/*surgery Bladder tumor Laser enucleation of bladder tumor Meta-analysis Transurethral resection of bladder tumor (TURBT)

Age Factors Aged Aged 80 and over Clinical Decision-Making *Cystectomy/adverse effects/mortality Disease-Free Survival Female Geriatric Assessment Humans Life Expectancy Male Middle Aged Neoplasm Invasiveness Odds Ratio Patient Selection Quality of Life Radiotherapy/adverse effects/mortality Risk Factors Time Factors Treatment Outcome Urinary Bladder Neoplasms/mortality/pathology/*therapy Complications Elderly Mibc Outcome

Cystectomy/*methods Disease-Free Survival Humans Lymphatic Metastasis *Margins of Excision Neoplasm Recurrence Local Neoplasm Staging Prognosis Treatment Outcome Urinary Bladder Neoplasms/pathology/*surgery bladder cancer meta-analysis outcome radical cystectomy surgical margin status