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6% for the no-NACT group (P= .01). The NACT group had fewer recurrences than the no-NACT group (10% vs 47.1%; P= .003). In the subgroup analysis, the lower rate of non-organ-confined disease persisted for the patients who underwent NACT at the lower SV percentage but failed to remain significant at greater percentage involvement. This was also true for overall survival. The effect of NACT in variant histology bladder cancer is variable. In patients with SV, these results favor the recommendation in favor of NACT administratio