@colleenyoung Colleen and other members, The second pathology showed extensive lamina propria invasion with focal abutment of the muscularis propria; definitive muscle invasion couldn’t be ruled out. Imaging (MRI pelvis, CT chest/abdomen) shows no spread. Given tumor volume, depth, and staging uncertainty, my team is treating this as early muscle-invasive disease and recommending neoadjuvant cisplatin-based chemotherapy (guided by Univ Miami /Sylvester GU Medical Oncology) followed by radical cystectomy at a high-volume center, with curative intent (performed at Cleveland Clinic FL). I’d appreciate hearing from others who faced a similar T1 vs early T2 gray-zone decision.