Soria F, et al. - In a large multicenter retrospective cohort of T1-HG/G3 patients first treated with BCG, researchers assessed if there is any oncological impact of delaying radical cystectomy (RC) to allow further conservative therapies before progression. Of 2,451 patients, 20.8% underwent RC. Compared to those who progressed prior to RC and those upstaged at surgery, better oncological and survival outcomes are seen in patients treated with RC before experiencing progression to muscle-invasive disease. The main predictors of surgical treatment are tumor size and concomitant CIS at diagnosis while an association of tumor size, CIS and tumor multiplicity was seen with extravesical disease at surgery.