Take Home MessageNo guideline recommendations exist for the treatment of cisplatin-ineligible patients with clinically lymph node–positive (cN+) bladder cancer. In this study, carboplatin-based induction chemotherapy appeared to be an attractive alternative before radical cystectomy for this population. In particular, patients with cN1 disease who are not eligible for cisplatin may benefit from gemcitabine/carboplatin induction chemotherapy.