A gene test helped predict the risk of node-positive disease in patients with bladder disease so that beneficial neoadjuvant chemotherapy could be administered before cystectomy, researchers reported in Lancet Oncology (2011;12:137-143).

The most important predictor of recurrence after cystectomy is pathologically positive nodes, so researchers sought a method of identifying bladder-cancer patients at risk for node-positive disease and could therefore benefit from surgery-delaying neoadjuvant chemotherapy. The 20-gene test identified individuals with high and low relative risks of nodal.