对于非肌肉侵袭性膀胱癌（NMIBC）的疾病进展高危和非常高危的患者，建议进行根治性膀胱切除术（RC）。然而，新辅助化疗（NAC）对接受RC的NMIBC患者的生存结局的影响仍不清楚。我们从监测、流行病学和终点事件（SEER）数据库中筛选出接受RC的T1高级别NMIBC患者。使用Kaplan-Meier技术评估总生存率（OS），并进行多变量Cox回归分析以确定OS的独立因素。研究纳入了2004年至2015年间共1268例接受了RC的T1高级别NMIBC患者。其中76例（6.0%）接受了NAC。在中位随访时间为75个月时，NAC组与非NAC组的OS没有显著差异（HR = 0.89，95% CI 0.61-1.30，P = .539）。然而，在多变量Cox回归模型中，NAC对OS的改善效果更为显著，且趋近于统计学意义（HR = 0.7，95% CI 0.47-1.05，P = .088）。亚组分析显示，在淋巴结转移患者中，NAC有助于生存。总之，本研究结果表明，NAC可能在接受RC的T1高级别NMIBC患者中提供生存优势，但需要进一步的研究。然而，对于淋巴结受累患者，NAC的生存益处是显而易见的。版权所有 © 2023作者。由Wolters Kluwer Health, Inc.出版。

Patients with non-muscle-invasive bladder cancer (NMIBC) who are at high and very high risk of disease progression are recommended for radical cystectomy (RC). However, the impact of neoadjuvant chemotherapy (NAC) on survival outcomes in NMIBC patients undergoing RC remains unclear. Patients diagnosed with T1 high-grade NMIBC who underwent RC were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) was assessed using the Kaplan-Meier technique, and multivariable Cox regression analysis was conducted to determine the independent factors of OS. A total of 1268 T1 high-grade NMIBC patients who underwent RC between 2004 and 2015 were included in the study. NAC was administered to 76 (6.0%) patients. At a median follow-up of 75 months, there was no significant difference in the OS between the NAC and non-NAC groups (HR = 0.89, 95% CI 0.61-1.30, P = .539). However, in the multivariate Cox regression model, NAC demonstrated a more pronounced improvement in OS approaching statistical significance (HR = 0.7, 95% CI 0.47-1.05, P = .088). Subgroup analysis revealed a survival benefit of NAC in patients with lymph node metastasis. In summary, the results of this study suggest that NAC has the potential to confer a survival advantage in patients diagnosed with T1 high-grade NMIBC who undergo RC, but additional studies are needed. Nonetheless, the survival benefits of NAC in patients with lymph node involvement are apparent.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.