It is estimated that clinical node-positive urothelial carcinoma of the bladder (cN+UCaB) affects approximately 5-10% of the patients that are diagnosed with muscle-invasive bladder cancer (MIBC).1 Its treatment presents a clinical challenge to the treating physician due to the ambiguity surrounding its regional versus metastatic classification. This is an important issue however as a significant proportion of these patients are still potentially ‘curable’ with timely care.2, 3 Given the paucity of literature on direct comparisons among the various available treatment options for these patients, we undertook the current study to examine the impact of local treatment regimens alongside systemic chemotherapy on outcomes in patients with cN+UCaB.