Sanchez A, et al. – The physicians conducted this work to present the incidence, clinicopathologic risk factors, management, and outcomes of non–muscle invasive bladder cancer (NMIBC) recurrences after complete response (CR) to tri–modality therapy (TMT) for muscle–invasive bladder cancer (MIBC). The data showed that 25% of patients after CR to TMT established a NMIBC recurrence with some emerging beyond a decade after TMT. It was noted that no baseline clinicopathologic characteristics were correlated with NMIBC recurrence after complete response. Importantly, patients with NMIBC recurrences have worse disease–specific compared to those without, though similar OS. Adjuvant intravesical BCG has a reasonable toxicity profile and efficacy in this population. In addition, properly selected patients with NMIBC recurrences after CR may avoid immediate salvage cystectomy.