Bladder cancer is a common urologic cancer and the 6th most common cancer in Canada. In terms of malignancy, this cancer has the highest recurrence rate. The most common type of bladder cancer is Transitional Cell Carcinoma (TCC). Worldwide, each year, bladder cancer is diagnosed in 275,000 people. In the past 10 years, bladder cancer accounted for 7.5% of all detected cancers in men and 1.8% of those of women in Canada. More than 2100 deaths per year occur in Canada as a result of bladder Cancer. Last year, a study at the Vanderbilt University Medical Center in Nashville illustrated that extended lymphadenectomy consistently provided an advantage over standard approaches at the time of cystectomy with insignificant increases in morbidity. We had similar questions and decided to do a study to build on current knowledge. In this report, I am comparing extended and standard approaches to lymph node removal with respect to complication risks, patient survival outcomes and neoadjuvant chemotherapy responses.