Bladder Preservation in MIBC: Promise and Caution in Neoadjuvant Therapy

In the ongoing effort to spare cancer patients from radical surgery, oncologists are confronting a humbling truth: what the eye sees, and what the body conceals, are not always the same. At the American Urological Association's 2026 plenary session, Enrique Grande and colleagues raised a measured alarm about bladder preservation strategies in muscle-invasive bladder cancer — not to dismiss hope, but to insist that hope be grounded in evidence. The promise of high pathologic response rates collides with the sobering reality that current tools for confirming tumor clearance remain imperfect, and