Outcome of radical cystectomy for invasive bladder cancer

Even though radical cystectomy still remains the 'gold standard' for the treatment of invasive bladder cancer, newer insights and developments are entering the urological arena: a 'tailored' surgical approach combining a less extensive procedure and a better quality of life seems feasible for selected patients without compromising the outcome; the type of urinary diversion has no impact on the risk of complications, the ability to receive postoperative salvage treatments and the natural history of the disease; the depth of extension of the tumour and the nodal involvement are the only independent 'classical' predictors of survival after radical cystectomy; pelvic node dissection is curative in patients with limited nodal involvement; the clinical application of newer molecular prognostic factors still remains controversial.