SynthesisBJU international2026
Clinical complete response as a surrogate for pathological response in bladder cancer: a systematic review and meta-analysis.
Synthesis in BJU international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Beyond staging: toward a layered risk architecture after radical cystectomy for bladder cancer.Translational andrology and urology · 2026Article
- Comparative efficacy of perioperative systemic therapies for muscle-invasive bladder cancer: a network meta-analysis of randomized trials.ESMO open · 2026Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the concordance between clinical complete response (cCR) and pathological complete response (pCR) in muscle-invasive bladder cancer (MIBC) to assess the surrogacy and prognostic value of cCR for guiding bladder-sparing strategies.
methodsIn this prospectively registered systematic review and meta-analysis (CRD420251066540), we searched MEDLINE, EMBASE, and Web of Science in June 2025 for studies reporting clinical and pathological complete response rates in patients with MIBC undergoing neoadjuvant therapy followed by radical cystectomy (RC). Pooled concordance was estimated via random-effects meta-analysis. Risk-of-bias was assessed using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I).
resultsOut of 1947 individual records, 10 (n = 894) retrospective and three (n = 181) prospective studies comprising 1075 patients were included. Restaging modalities for cCR assessment included transurethral resection of the bladder (TURB; n = 188, two studies), computed tomography (n = 221, two studies), magnetic resonance imaging (MRI; n = 122, two studies), and fluorodeoxyglucose positron emission tomography (n = 45). One study (n = 56) used perioperative cystoscopy, while the remaining five studies (n = 499) combined imaging with cystoscopy or TURB. The concordance (n = 779, nine studies) between cCR and pCR was 0.51 (95% confidence interval [CI] 0.42-0.60), the concordance (n = 536, seven studies) between non-cCR and non-pCR was 0.84 (95% CI 0.70-0.92). Most studies were rated as having moderate concerns regarding bias, and one as serious due to examiner-dependent bias of cystoscopy-based cCR assessment.
conclusionCurrent evidence does not support relying on the current definition of cCR alone, which poorly predicts pCR, to guide treatment decisions. Ongoing trials assessing the combination of MRI plus TURB with urine and/or blood based circulating tumour DNA may help refine cCR evaluation and support the sole introduction of bladder-sparing approaches in patients with MIBC who respond to neoadjuvant systemic therapy.
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