Within 90 days of cystectomy , patients were centrally randomly assigned ( 1:1 ) by minimisation to either immediate adjuvant chemotherapy ( four cycles of gemcitabine plus cisplatin , high-dose methotrexate , vinblastine , doxorubicin , and cisplatin [ high-dose MVAC ] , or MVAC ) or six cycles of deferred chemotherapy at relapse , with stratification for institution , pT category , and lymph node status according to the number of nodes dissected .