What Is the Optimal Perioperative Treatment for Variant Subtypes of Bladder Cancer?

Urothelial carcinoma subtypes are classified according to the 2022 World Health Organization scheme and are generally high-risk cancers that require multidisciplinary evaluation and management whenever possible. Perioperative systemic therapies (neoadjuvant and adjuvant) should be considered for subtypes that are responsive, but some very rare subtypes do not respond well to systemic therapy. Concerted efforts are needed to identify better therapies for these tumors.