Kapadia AA, et al. - This cohort study was conducted to investigate the factors that predict failure to receive surgery after multi-agent chemotherapy for non-metastatic muscle-invasive bladder cancer. The factors that predicted failure to receive surgery were increasing age, African-American or Hispanic race, and longer time to chemotherapy. Also, the African-American race was noted to be related to a delay in chemotherapy. Patients on medicare or other government insurance demonstrated a delay in chemotherapy. The longer the time to neoadjuvant chemotherapy is a modifiable risk factor that should be closely observed in multi-modal cancer treatment.