FIG. 50:  A trial carried out at Memorial Sloan Kettering Cancer Center found no difference in mortality between immediate radical cystectomy vs no immediate radical cystectomy.^[68]  The interesting factor for predicting outcomes was optimal patient selection by the physician.  No single factor determined of which patients should have received immediate radical cystectomy; rather probably a composition of multiple factors, as discussed previously, should determine which patients should be a candidate for early radical cystectomy, and this should be discussed with every patient.