[Liquid biopsy empowers precision medicine across the full course of bladder cancer]

Bladder cancer management encompasses the entire clinical course, including screening, diagnosis, treatment decision-making, and recurrence monitoring. Although conventional approaches based on cystoscopy, imaging, and histopathology remain the foundation of clinical practice, they have limitations in noninvasive dynamic monitoring and molecular stratification. By analyzing tumor-derived cells and molecular information in urine or blood, liquid biopsy provides an important complementary approach for precision management of bladder cancer across the disease course. Owing to the direct contact between bladder tumors and urine, urine-based liquid biopsy is more suitable for screening, adjunctive diagnosis, and intravesical recurrence monitoring. In contrast, blood-based liquid biopsy better reflects systemic tumor biology and has potential value in perioperative adjuvant treatment decision-making and treatment response monitoring. These two approaches have distinct focuses and complementary roles across different disease stages and clinical scenarios. Nevertheless, the clinical translation of liquid biopsy still faces challenges, including insufficient sample standardization, heterogeneous detection systems, and relatively high costs. Future efforts should further define its complementary role within existing guideline-based pathways, optimize biomarker panels, standardize detection procedures, and promote its integration into precision management of bladder cancer through prospective studies.