<p><strong> </strong><strong>Due to the high rate of upstaging associated with subtype histology, clinicians should discuss the option of early radical cystectomy with the patient. (<em>Expert Opinion</em>)</strong></p>
Discussion
Discussion
<p>There is a lack of evidence regarding the efficacy of intravesical therapy for patients with non-muscle invasive urothelial carcinoma with subtype histology.<sup>99-101, 104-108</sup> Management may vary according to the specific histologic subtype and extent of subtype differentiation, especially as we learn more about these subtypes. An example is the small cell/neuroendocrine subtype that may warrant systemic therapy followed by consolidative local therapy because of its aggressive biologic behavior and high metastatic potential.<sup>109</sup></p>