Determining the Role of Cystectomy for High-grade T1 Urothelial Carcinoma

High-grade T1 (HGT1) urothelial carcinoma is an invasive disease with high predisposition for recurrence and progression. The optimal treatment of HGT1 disease remains controversial. Clinical HGT1 disease represents a heterogeneous group of patients with variable clinical behavior. Radical cystectomy for HGT1 disease is associated with excellent survival and offers the best opportunity for cure; however, it has a potential cost of decrease in quality of life. This article summarizes features associated with increased risk of progression and provides a framework for optimal treatment strategy with a focus on the role of radical cystectomy for HGT1 disease.