The Role of Surgery in Locally Advanced and Oligometastatic Bladder Cancer.

The role of surgery in the multimodal management of locally advanced and oligometastatic bladder cancer remains critical but incompletely defined. While current evidence is predominantly derived from retrospective series and institutional experiences, both metastasectomy and consolidative lymphadenectomy have demonstrated potential survival benefits in carefully selected patients following systemic therapy. However, interpretation of these data is hampered by the absence of standardized definitions, small and heterogeneous patient cohorts, and a lack of prospective, randomized trials. Ongoing clinical trials aim to refine patient selection criteria and clarify the role of surgery within modern therapeutic algorithms.