Reply to Can Lu and Xiao Guan`s Letter to the Editor re: Marko Babjuk. Are the Role of Surgery and its Complications Sufficiently Focused in the Era of Perioperative Systemic Treatments? Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.01.022 (European Urology)

I appreciated the letter from Lu and Guan discussing the potential consequences of the economic burden associated with neoadjuvant immunotherapy before radical cystectomy in patients with operable muscle-invasive bladder cancer. Although my Platinum Priority editorial [1] and the original paper by Briganti et al [2] focused mostly on the role of surgery in the complex approach to these cases, I agree that economic aspects are important and could impact utilization of the optimal treatment modality.