Evidence map›Paper›PMID 39324506›Full record

Trial reportBJU international2025

Real-world outcomes for high-risk non-muscle-invasive bladder cancer: screened patients for the BRAVO trial.

Samantha Conroy, Ibrahim Jubber, Aidan P Noon, Derek J Rosario, Jon Griffin, Susan Morgan, Rachel Hubbard, Steve Kennish, Stephen Mitchell, Suresh Venugopal and 4 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BJU international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Cancer Immunotherapy-An Overview.Cancer treatment and research · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Samantha ConroyDivision of Clinical Medicine, University of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0001-7167-4908
Ibrahim JubberDivision of Clinical Medicine, University of Sheffield, Sheffield, UK.
Aidan P NoonDepartment of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Derek J RosarioDepartment of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Jon GriffinDivision of Clinical Medicine, University of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0003-3969-7637
Susan MorganDepartment of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Rachel HubbardDepartment of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Steve KennishDepartment of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Stephen MitchellDepartment of Urology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust, High Wycombe, UK.
Suresh VenugopalDepartment of Urology, The Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK.
Kate LintonDepartment of Urology, Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK.
Ramanan RajasundaramDepartment of Urology, Doncaster Royal Infirmary, Doncaster, UK.
Syed A HussainDivision of Clinical Medicine, University of Sheffield, Sheffield, UK.
James W F CattoDivision of Clinical Medicine, University of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0003-2787-8828

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo report real-world outcomes for high-risk non-muscle-invasive bladder cancer (HRNMIBC), including bacillus Calmette-Guérin (BCG) and radical cystectomy (RC), as randomised comparisons of these have not been possible.

methodsWe detail consecutive participants screened for the BRAVO randomised controlled trial comparing RC with BCG (International Standard Randomised Controlled Trial Number [ISRCTN]12509361). Patients were prospectively registered and case-note review used for outcomes. The primary outcome was overall survival. Secondary outcomes included recurrence, progression, metastasis, and bladder cancer-specific survival. RESULTS AND LIMITATIONS: A total of 193 patients were screened, including 106 (54.9%) who received BCG, 43 (22.3%) primary RC, 37 (19.2%) 'other' treatment and seven (3.6%) hyperthermic intravesical mitomycin C. All-cause death occurred in 55 (28.5%) patients at median (interquartile range [IQR]) of 29.0 (19.5-42.0) months. In multivariable analysis, overall mortality was more common in older patients (hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.35-5.13; Cox P = 0.004 for age >70 years), those recruited from district hospitals (HR 0.53, 95% CI 0.3-0.95; P = 0.032) and those who did not undergo RC as their first treatment (HR 2.16, 95% CI 1.17-3.99; P = 0.014). In all, 17 (8.8%) patients died from bladder cancer (BC) at median (IQR) of 22.5 (19-36.25) months. In multivariable analysis, BC-specific mortality was more common in older patients (HR 4.87, 95% CI 1.1-21.6; P = 0.037) and those with Tis/T1 disease (HR 2.26, 95% CI 1.23-4.16; P = 0.008) but did not vary with initial treatment.

conclusionsPatients with HRNMIBC are at high-risk of mortality. Those choosing RC as their initial treatment have lower risks of mortality than others, although this may reflect fitness and selection.

Indexed as

BCG VaccineCystectomyUrinary Bladder NeoplasmsAdjuvants, ImmunologicAgedAged, 80 and overFemaleHumansMaleMiddle AgedMitomycinNeoplasm InvasivenessNon-Muscle Invasive Bladder NeoplasmsProspective StudiesTreatment OutcomeAdjuvants, ImmunologicBCG VaccineMitomycinBCGbladder cancerfeasibility studyHigh‐risk non‐muscle‐invasive bladder cancerradical cystectomyRCTreal‐world datasurgical trial

Identifiers

PMID39324506
PMCPMC11745995

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.