FIG. 57:  One promising avenue toward identification of bladder cancer molecular subtypes is the molecular pathologic framework for risk stratification according to 3 molecular subtypes.  Different groups, including Swedish researchers,^[75] have identified different molecular subtypes similar to those already identified in breast cancer and other cancers.  The urobasal, genomically unstable, or squamous-cell carcinoma-like subtypes are present in different groups of patients, according to which patients are seen in any given clinic.  T1 disease can be classified into these 3 subtypes, and the high risk of progression associated with the genomic unstable and the squamous-cell carcinoma-like subtypes might indicate that they should be treated more aggressively initially or even be treated with early or immediate radical cystectomy.