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The long-term outcome of treated high-risk nonmuscle-invasive bladder cancer

This paper reports conclusive results of the work presented in the previous papers on bladder cancer. High risk bladder cancer is difficult to predict and treat. Surveillance and bacillus Chalmette-Guerin were ineffective in altering the natural history of the disease. The authors concluded that the time has come to rethink the paradigm of management of this disease and recommend that radical cystectomy is likely to be more effective and more cost effective at preventing disease progression than bladder sparing treatment.