Trimodal therapy shows potential as an alternative to radical cystectomy for recurrent high-grade T1 bladder cancer, with 88% of patients avoiding cystectomy at 3 years post-treatment. The therapy, involving radiation with radiosensitizing chemotherapy following repeated transurethral resection, reported overall survival rates of 69% at 3 years and 56% at 5 years, with 12% and 19% distant metastasis rates, respectively. Despite limitations in cohort size and participant heterogeneity, the study suggests this approach could be considered in place of cystectomy.