Adult Aged Aged 80 and over Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use B7-H1 Antigen/antagonists & inhibitors Carcinoma/*drug therapy/immunology/mortality/pathology Clinical Decision-Making Female Humans Immune Checkpoint Inhibitors/adverse effects/*therapeutic use Male Middle Aged Patient Selection Progression-Free Survival Time Factors Urinary Bladder Neoplasms/*drug therapy/immunology/mortality/pathology Urothelium/*drug effects/immunology/pathology Immune-checkpoint inhibitor Meta-analysis Programmed death-ligand 1 Urothelial carcinoma interests/personal relationships which may be considered as potential competing interests: The authors certify that all conflicts of interest including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the article are listed as follows: Shahrokh Shariat owns or co-owns the following patents: methods to determine prognosis after therapy for prostate cancer. Granted 2002-09-06. Methods to determine prognosis after therapy for bladder cancer. Granted 2003-06-19. Prognostic methods for patients with prostatic disease. Granted 2004-08-05. Soluble Fas: urinary marker for the detection of bladder transitional cell carcinoma. Granted 2010-07-20. He has a consulting or advisory role for the following: Astellas Astra Zeneca Bayer BMS Cepheid Ferring Ipsen Jansen Lilly MSD Olympus Pfizer Pierre Fabre Roche Sanochemia Sanofi Takeda Urogen and Wolff. All remaining authors have declared no conflicts of interest.

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.