Radical cystectomy with pelvic lymph node dissection is the standart method used to treat patients with muscle-invasive bladder cancer. However, in selected cases, one of the therapeutic options is bladder preservation, which consist of a complete transurethral resection of the tumor followed by systemic chemotherapy, radiation therapy or a combination of both. In 10-15% of patients with muscle-invasive disease have no pathologic residual disease at the time of cystectomy, indicating that transurethral resection of the bladder alone can potentially cure some patients. However, the absence of residual disease at transurethral resection of the bladder does not mean that patients are necessarily cured. Because, many patients with invasive bladder cancer have micrometastatic disease at the time of presentation. The limited efficacy of surgery alone and the introduction of effective combination chemotherapy has led to a multidisciplinary approach to bladder preservation.