{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T19:37:09Z","timestamp":1769283429080,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To report real\u2010world outcomes for high\u2010risk non\u2010muscle\u2010invasive bladder cancer (HRNMIBC), including bacillus Calmette\u2010Gu\u00e9rin (BCG) and radical cystectomy (RC), as randomised comparisons of these have not been possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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\u2010note review used for outcomes. The primary outcome was overall survival. Secondary outcomes included recurrence, progression, metastasis, and bladder cancer\u2010specific survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and limitations<\/jats:title>\n                    <jats:p>\n                      A total of 193 patients were screened, including 106 (54.9%) who received BCG, 43 (22.3%) primary RC, 37 (19.2%) \u2018other\u2019 treatment and seven (3.6%) hyperthermic intravesical mitomycin C. All\u2010cause death occurred in 55 (28.5%) patients at median (interquartile range [IQR]) of 29.0\u2009(19.5\u201342.0)\u2009months. In multivariable analysis, overall mortality was more common in older patients (hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.35\u20135.13; Cox\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004 for age &gt;70\u2009years), those recruited from district hospitals (HR 0.53, 95% CI 0.3\u20130.95;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032) and those who did not undergo RC as their first treatment (HR 2.16, 95% CI 1.17\u20133.99;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.014). In all, 17 (8.8%) patients died from bladder cancer (BC) at median (IQR) of 22.5\u2009(19\u201336.25)\u2009months. In multivariable analysis, BC\u2010specific mortality was more common in older patients (HR 4.87, 95% CI 1.1\u201321.6;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.037) and those with Tis\/T1 disease (HR 2.26, 95% CI 1.23\u20134.16;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008) but did not vary with initial treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with HRNMIBC are at high\u2010risk of mortality. Those choosing RC as their initial treatment have lower risks of mortality than others, although this may reflect fitness and selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16516","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T06:45:01Z","timestamp":1727333101000},"page":"329-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Real\u2010world outcomes for high\u2010risk non\u2010muscle\u2010invasive bladder cancer: screened patients for the\n                    <scp>BRAVO<\/scp>\n                    trial"],"prefix":"10.1111","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7167-4908","authenticated-orcid":false,"given":"Samantha","family":"Conroy","sequence":"first","affiliation":[{"name":"Division of Clinical Medicine University of Sheffield  Sheffield UK"},{"name":"Department of Urology Sheffield Teaching Hospitals NHS 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