Trial Outcomes & Findings for CISTO: Comparison of Intravesical Therapy and Surgery as Treatment Options for Bladder Cancer (NCT NCT03933826)

NCT ID: NCT03933826

Last Updated: 2025-11-04

Results Overview

Patient-reported quality of life is measured by the EORTC QLQ-C30 Physical Function scale. The scale ranges in score from 0 to 100, with higher function scores indicating better health. Scale score is calculated by transforming individual item scores into a 0 to 1 scale, taking the mean, and multiplying by 100. Each scale requires responses for at least 50% of the items in order to be calculated.

Recruitment status

ACTIVE_NOT_RECRUITING

Target enrollment

570 participants

Primary outcome timeframe

60 months after enrollment

Results posted on

2025-11-04

Participant Flow

Participant milestones

Participant milestones
Measure
Patients who have selected bladder-sparing therapy
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patients who have selected radical cystectomy
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Overall Study
STARTED
371
199
Overall Study
12-months from enrollment
303
174
Overall Study
COMPLETED
303
174
Overall Study
NOT COMPLETED
68
25

Reasons for withdrawal

Reasons for withdrawal
Measure
Patients who have selected bladder-sparing therapy
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patients who have selected radical cystectomy
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Overall Study
Withdrawal by Subject
8
1
Overall Study
Death
19
11
Overall Study
Lost to Follow-up
41
13

Baseline Characteristics

CISTO: Comparison of Intravesical Therapy and Surgery as Treatment Options for Bladder Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Patients who have selected bladder-sparing therapy
n=371 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patients who have selected radical cystectomy
n=199 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Total
n=570 Participants
Total of all reporting groups
Sex: Female, Male
Male
293 Participants
n=15 Participants
160 Participants
n=161 Participants
453 Participants
n=100 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
39 Participants
n=15 Participants
17 Participants
n=161 Participants
56 Participants
n=100 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
332 Participants
n=15 Participants
182 Participants
n=161 Participants
514 Participants
n=100 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=15 Participants
0 Participants
n=161 Participants
0 Participants
n=100 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=15 Participants
0 Participants
n=161 Participants
1 Participants
n=100 Participants
Race (NIH/OMB)
Asian
6 Participants
n=15 Participants
4 Participants
n=161 Participants
10 Participants
n=100 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=15 Participants
0 Participants
n=161 Participants
0 Participants
n=100 Participants
Race (NIH/OMB)
Black or African American
18 Participants
n=15 Participants
8 Participants
n=161 Participants
26 Participants
n=100 Participants
Race (NIH/OMB)
White
341 Participants
n=15 Participants
184 Participants
n=161 Participants
525 Participants
n=100 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants
n=15 Participants
2 Participants
n=161 Participants
6 Participants
n=100 Participants
Partner status
Partnered
288 Participants
n=15 Participants
170 Participants
n=161 Participants
458 Participants
n=100 Participants
Partner status
Unpartnered
83 Participants
n=15 Participants
29 Participants
n=161 Participants
112 Participants
n=100 Participants
Age, Continuous
72.4 years
STANDARD_DEVIATION 8.3 • n=15 Participants
69.6 years
STANDARD_DEVIATION 9.1 • n=161 Participants
71.4 years
STANDARD_DEVIATION 8.7 • n=100 Participants
Age, Customized
greater than or equal to 75 years
150 Participants
n=15 Participants
62 Participants
n=161 Participants
212 Participants
n=100 Participants
Age, Customized
Less than 75 years
221 Participants
n=15 Participants
137 Participants
n=161 Participants
358 Participants
n=100 Participants
Sex: Female, Male
Female
78 Participants
n=15 Participants
39 Participants
n=161 Participants
117 Participants
n=100 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=15 Participants
1 Participants
n=161 Participants
2 Participants
n=100 Participants

PRIMARY outcome

Timeframe: 12 months after enrollment

Population: We performed tenfold multiple imputation (MICE R package) for all missing outcomes and covariates for analyses of all patient-reported outcomes.

The primary outcome of patient-reported quality of life is measured by the EORTC QLQ-C30 Physical Function scale. The scale ranges in score from 0 to 100, with higher function scores indicating better health. Scale score is calculated by transforming individual item scores into a 0 to 1 scale, taking the mean, and multiplying by 100. Each scale requires responses for at least 50% of the items in order to be calculated.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=174 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=304 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient-reported Quality of Life as Measured by the Physical Function Scale of the European Organization for Research and Treatment of Cancer Quality-of-Life-Questionnaire-Core-30 (EORTC QLQ-C30)
86.5 score on a scale
Standard Deviation 17.5
85.0 score on a scale
Standard Deviation 18.9

PRIMARY outcome

Timeframe: 24 months after enrollment

Patient-reported quality of life is measured by the EORTC QLQ-C30 Physical Function scale. The scale ranges in score from 0 to 100, with higher function scores indicating better health. Scale score is calculated by transforming individual item scores into a 0 to 1 scale, taking the mean, and multiplying by 100. Each scale requires responses for at least 50% of the items in order to be calculated.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: 60 months after enrollment

Patient-reported quality of life is measured by the EORTC QLQ-C30 Physical Function scale. The scale ranges in score from 0 to 100, with higher function scores indicating better health. Scale score is calculated by transforming individual item scores into a 0 to 1 scale, taking the mean, and multiplying by 100. Each scale requires responses for at least 50% of the items in order to be calculated.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after enrollment

Population: We imputed missing outcomes and covariates for TMLE analyses of this outcome. Therefore, all participants who enrolled in CISTO are included whether or not they completed that outcome. The mean and standard deviation for this outcome was calculated using only participants who completed this outcome (n = 292 and 166 for bladder-sparing therapy and radical cystectomy arms, respectively).

The evaluation of the effect of treatment choice on patient-reported urinary health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate the two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=166 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=292 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Self-reported Urinary Health as Measured by the Bladder Cancer Index Urinary Summary Score
83.8 score on a scale
Standard Deviation 14.2
85.3 score on a scale
Standard Deviation 16.7

SECONDARY outcome

Timeframe: 24 months after enrollment

The evaluation of the effect of treatment choice on patient-reported urinary health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate the two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after enrollment

The evaluation of the effect of treatment choice on patient-reported urinary health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate the two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after enrollment

Population: We imputed missing outcomes and covariates for TMLE analyses of this outcome. Therefore, all participants who enrolled in CISTO are included whether or not they completed that outcome. The mean and standard deviation for this outcome was calculated using only participants who completed this outcome (n = 238 and 143 for bladder-sparing therapy and radical cystectomy arms, respectively).

The evaluation of the effect of treatment choice on patient-reported sexual health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=143 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=238 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Self-reported Sexual Health as Measured by the Bladder Cancer Index Sexual Summary Score
32.6 score on a scale
Standard Deviation 20.1
47.1 score on a scale
Standard Deviation 25.7

SECONDARY outcome

Timeframe: 24 months after enrollment

The evaluation of the effect of treatment choice on patient-reported sexual health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after enrollment

The evaluation of the effect of treatment choice on patient-reported sexual health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after enrollment

Population: We imputed missing outcomes and covariates for TMLE analyses of this outcome. Therefore, all participants who enrolled in CISTO are included whether or not they completed that outcome. The mean and standard deviation for this outcome was calculated using only participants who completed this outcome (n = 293 and 166 for bladder-sparing therapy and radical cystectomy arms, respectively).

The evaluation of the effect of treatment choice on patient-reported bowel health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=166 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=293 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Self-reported Bowel Health as Measured by the Bladder Cancer Index Bowel Summary Score
77.2 score on a scale
Standard Deviation 10.8
80.1 score on a scale
Standard Deviation 9.5

SECONDARY outcome

Timeframe: 24 months after enrollment

The evaluation of the effect of treatment choice on patient-reported bowel health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after enrollment

The evaluation of the effect of treatment choice on patient-reported bowel health, as measured by the Bladder Cancer Index (BCI). The BCI consists of 36 items, with 4- or 5-point Likert response scales, covering 3 primary domains: urinary, bowel, and sexual. For each domain a summary score is constructed from the items used to calculate two subscale scores (function and bother). Scores are calculated by transforming item responses into a 0 to 100 scale and calculating the mean of the standardized items. Higher scores indicate better health status. To calculate a score, a minimum of 80% completed items is required.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after enrollment

Population: We imputed missing outcomes and covariates for TMLE analyses of this outcome. Therefore, all participants who enrolled in CISTO are included whether or not they completed that outcome. The mean and standard deviation for this outcome was calculated using only participants who completed this outcome (n = 288 and 167 for bladder-sparing therapy and radical cystectomy arms, respectively).

The evaluation of the effect of treatment choice on patient-reported financial distress, as measured by the Comprehensive Score for Financial Toxicity (COST). The COST questionnaire consists of 11 items, each scored on a 5-point Likert scale from zero to four. After reversing some items as indicated in the scoring manual (by reversing the sign on the original zero to four score and adding four), all item response scores are summed into a single financial toxicity score ranging from 0 to 44, with higher scores indicating greater financial wellbeing. Each subscale requires responses for at least 50% of the items in that subscale in order to be calculated. Item nonresponse is accounted for by substituting the mean of the completed items in the subscale.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=166 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=288 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Self-reported Financial Distress as Measured by the Comprehensive Score for Financial Toxicity (COST)
31.0 score on a scale
Standard Deviation 9.4
30.4 score on a scale
Standard Deviation 9.9

SECONDARY outcome

Timeframe: 24 months after enrollment

The evaluation of the effect of treatment choice on patient-reported financial distress, as measured by the Comprehensive Score for Financial Toxicity (COST). The COST questionnaire consists of 11 items, each scored on a 5-point Likert scale from zero to four. After reversing some items as indicated in the scoring manual (by reversing the sign on the original zero to four score and adding four), all item response scores are summed into a single financial toxicity score ranging from 0 to 44, with higher scores indicating greater financial wellbeing. Each subscale requires responses for at least 50% of the items in that subscale in order to be calculated. Item nonresponse is accounted for by substituting the mean of the completed items in the subscale.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after enrollment

The evaluation of the effect of treatment choice on patient-reported financial distress, as measured by the Comprehensive Score for Financial Toxicity (COST). The COST questionnaire consists of 11 items, each scored on a 5-point Likert scale from zero to four. After reversing some items as indicated in the scoring manual (by reversing the sign on the original zero to four score and adding four), all item response scores are summed into a single financial toxicity score ranging from 0 to 44, with higher scores indicating greater financial wellbeing. Each subscale requires responses for at least 50% of the items in that subscale in order to be calculated. Item nonresponse is accounted for by substituting the mean of the completed items in the subscale.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after enrollment

Population: We imputed missing outcomes and covariates for TMLE analyses of this outcome. Therefore, all participants who enrolled in CISTO are included whether or not they completed that outcome. The mean and standard deviation for this outcome was calculated using only participants who completed this outcome (n = 294 and 169 for bladder-sparing therapy and radical cystectomy arms, respectively).

The evaluation of patient-reported anxiety, as measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Anxiety 4a. Scores range from 0 to 100, with higher scores indicating greater symptoms. Scores are normalized to a mean of 50 and standard deviation of 10.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=169 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=294 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient-reported Anxiety as Measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Anxiety 4a
48.8 T-score
Standard Deviation 8.9
50.0 T-score
Standard Deviation 8.9

SECONDARY outcome

Timeframe: 24 months after enrollment

The evaluation of patient-reported anxiety, as measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Anxiety 4a. Scores range from 0 to 100, with higher scores indicating greater symptoms. Scores are normalized to a mean of 50 and standard deviation of 10.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after enrollment

The evaluation of patient-reported anxiety, as measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Anxiety 4a. Scores range from 0 to 100, with higher scores indicating greater symptoms. Scores are normalized to a mean of 50 and standard deviation of 10.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after enrollment

Population: We imputed missing outcomes and covariates for TMLE analyses of this outcome. Therefore, all participants who enrolled in CISTO are included whether or not they completed that outcome. The mean and standard deviation for this outcome was calculated using only participants who completed this outcome (n = 294 and 169 for bladder-sparing therapy and radical cystectomy arms, respectively).

The evaluation of patient-reported depression, as measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Depression 4a. Scores range from 0 to 100, with higher scores indicating greater symptoms. Scores are normalized to a mean of 50 and standard deviation of 10.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=169 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=294 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient-reported Depression as Measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Depression 4a
48.0 T-score
Standard Deviation 8.2
48.0 T-score
Standard Deviation 8.3

SECONDARY outcome

Timeframe: 24 months after enrollment

The evaluation of patient-reported depression, as measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Depression 4a. Scores range from 0 to 100, with higher scores indicating greater symptoms. Scores are normalized to a mean of 50 and standard deviation of 10.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after enrollment

The evaluation of patient-reported depression, as measured by the Patient Reported Outcome Measurement Information System (PROMIS) Short Form v1.0 - Depression 4a. Scores range from 0 to 100, with higher scores indicating greater symptoms. Scores are normalized to a mean of 50 and standard deviation of 10.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after enrollment

Population: We imputed missing outcomes and covariates for TMLE analyses of this outcome. Therefore, all participants who enrolled in CISTO are included whether or not they completed that outcome. The mean and standard deviation for this outcome was calculated using only participants who completed this outcome (n = 278 and 162 for bladder-sparing therapy and radical cystectomy arms, respectively).

The evaluation of patient-reported generic quality of life as measured by the EuroQoL EQ-5D-5L (EQ-5D). Scores range from 0 to 1, with higher scores indicating better health.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=162 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=278 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient-reported Generic Quality of Life as Measured by the EuroQoL EQ-5D-5L
0.86 score on a scale
Standard Deviation 0.13
0.84 score on a scale
Standard Deviation 0.14

SECONDARY outcome

Timeframe: 24 months after enrollment

The evaluation of patient-reported generic quality of life as measured by the EuroQoL EQ-5D-5L (EQ-5D). Scores range from 0 to 1, with higher scores indicating better health.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after enrollment

The evaluation of patient-reported generic quality of life as measured by the EuroQoL EQ-5D-5L (EQ-5D). Scores range from 0 to 1, with higher scores indicating better health.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment

Population: All participants who had an electronic health record review or death record at least 12 months after the diagnosis of recurrent high-grade non-muscle invasive bladder cancer. Survival times were calculated from the date of recurrence to the event (metastasis or death). Censoring occurred at the last electronic health record review or death.

The evaluation of the effect of treatment choice on recurrence-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (recurrence or death). A recurrence was defined as any subsequent episode of high-grade bladder cancer in the bladder or elsewhere in the urinary tract (penile urethra, prostatic urethra, ureters, renal pelvis), either non-muscle or muscle invasive bladder cancer (for cystectomy arm this excludes any finding at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=192 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=356 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Recurrence-free Survival
176 Participants
226 Participants

SECONDARY outcome

Timeframe: 24 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on recurrence-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (recurrence or death). A recurrence was defined as any subsequent episode of high-grade bladder cancer in the bladder or elsewhere in the urinary tract (penile urethra, prostatic urethra, ureters, renal pelvis), either non-muscle or muscle invasive bladder cancer (for cystectomy arm this excludes any finding at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on recurrence-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (recurrence or death). A recurrence was defined as any subsequent episode of high-grade bladder cancer in the bladder or elsewhere in the urinary tract (penile urethra, prostatic urethra, ureters, renal pelvis), either non-muscle or muscle invasive bladder cancer (for cystectomy arm this excludes any finding at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment

Population: All participants who had an electronic health record review or death record at least 12 months after the diagnosis of recurrent high-grade non-muscle invasive bladder cancer. Survival times were calculated from the date of recurrence to the event (metastasis or death). Censoring occurred at the last electronic health record review or death.

The evaluation of the effect of treatment choice on metastasis-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (metastatis or death). A metastasis was defined as metastasis to distant lymph/nodes organs (pathologic or radiologic diagnosis of M+ disease) (for cystectomy arm this includes findings at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=192 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=349 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Metastasis-free Survival
178 Participants
330 Participants

SECONDARY outcome

Timeframe: 24 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on metastasis-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (metastatis or death). A metastasis was defined as metastasis to distant lymph/nodes organs (pathologic or radiologic diagnosis of M+ disease) (for cystectomy arm this includes findings at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on metastasis-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (metastatis or death). A metastasis was defined as metastasis to distant lymph/nodes organs (pathologic or radiologic diagnosis of M+ disease) (for cystectomy arm this includes findings at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment

Population: All participants who had an electronic health record review or death record at least 12 months after the diagnosis of recurrent high-grade non-muscle invasive bladder cancer. Survival times were calculated from the date of recurrence to the event (progression or death). Censoring occurred at the last electronic health record review or death.

The evaluation of the effect of treatment choice on metastasis-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (metastatis or death). A progression was defined as any subsequent episode of muscle-invasive (T2-T4) disease in the bladder or elsewhere in the urinary tract AND/OR locoregional (true pelvic/common iliac) nodal disease (N+) AND/OR distant metastasis (M+) (for cystectomy arm this includes findings at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=194 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=349 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Progression-free Survival
141 Participants
319 Participants

SECONDARY outcome

Timeframe: 24 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on metastasis-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (metastatis or death). A progression was defined as any subsequent episode of muscle-invasive (T2-T4) disease in the bladder or elsewhere in the urinary tract AND/OR locoregional (true pelvic/common iliac) nodal disease (N+) AND/OR distant metastasis (M+) (for cystectomy arm this includes findings at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on metastasis-free survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (metastatis or death). A progression was defined as any subsequent episode of muscle-invasive (T2-T4) disease in the bladder or elsewhere in the urinary tract AND/OR locoregional (true pelvic/common iliac) nodal disease (N+) AND/OR distant metastasis (M+) (for cystectomy arm this includes findings at cystectomy). Censoring occurred at the last electronic health record review or death.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment

Population: All participants who had an electronic health record review or death record at least 12 months after the diagnosis of recurrent high-grade non-muscle invasive bladder cancer. Survival times were calculated from the date of recurrence to the event (death from bladder cancer). Censoring occurred at the last electronic health record review or death from bladder cancer.

The evaluation of the effect of treatment choice on bladder cancer-specific survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (death from bladder cancer). Censoring occurred at the last electronic health record review or date of death from bladder cancer.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=199 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=364 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Bladder Cancer-specific Survival
192 Participants
359 Participants

SECONDARY outcome

Timeframe: 24 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on bladder cancer-specific survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (death from bladder cancer). Censoring occurred at the last electronic health record review or date of death from bladder cancer.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on bladder cancer-specific survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (death from bladder cancer). Censoring occurred at the last electronic health record review or date of death from bladder cancer.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment

Population: All participants who had an electronic health record review or submitted a survey at least 12 months after the diagnosis of recurrent high-grade non-muscle invasive bladder cancer or had a death record at any time were included. Participants who did not have an electronic health record review or submit a survey at least 12 months after the diagnosis of recurrent high-grade non-muscle invasive bladder cancer and did not have a death record at any time were excluded.

The evaluation of the effect of treatment choice on overall survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (death). Censoring occurred at the last electronic health record review or date of death.

Outcome measures

Outcome measures
Measure
Patients who have selected radical cystectomy
n=199 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy
Patients who have selected bladder-sparing therapy
n=364 Participants
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patient Overall Survival
190 Participants
351 Participants

SECONDARY outcome

Timeframe: 24 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on overall survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (death). Censoring occurred at the last electronic health record review or date of death.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 60 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer

The evaluation of the effect of treatment choice on overall survival. Survival times were calculated from the date of diagnosis of recurrent high-grade non-muscle invasive bladder cancer to the event (death). Censoring occurred at the last electronic health record review or date of death.

Outcome measures

Outcome data not reported

Adverse Events

Patients who have selected bladder-sparing therapy

Serious events: 25 serious events
Other events: 77 other events
Deaths: 19 deaths

Patients who have selected radical cystectomy

Serious events: 29 serious events
Other events: 73 other events
Deaths: 11 deaths

Serious adverse events

Serious adverse events
Measure
Patients who have selected bladder-sparing therapy
n=371 participants at risk
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patients who have selected radical cystectomy
n=199 participants at risk
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy (RC)
Infections and infestations
Abdominal infection
0.27%
1/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
1.0%
2/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Infections and infestations
Lung infection
0.27%
1/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
0.50%
1/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Respiratory, thoracic and mediastinal disorders
Dyspnea
0.00%
0/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
0.50%
1/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Gastrointestinal disorders
Small intestinal obstruction
0.00%
0/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
1.0%
2/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Infections and infestations
Sepsis
0.81%
3/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
1.5%
3/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Renal and urinary disorders
Urinary tract obstruction
0.00%
0/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
0.50%
1/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Respiratory, thoracic and mediastinal disorders
Pneumothorax
0.54%
2/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
0.00%
0/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Surgical and medical procedures
Postoperative hemorrhage
0.27%
1/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
0.00%
0/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Cardiac disorders
Chest pain - cardiac
0.27%
1/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
0.00%
0/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Surgical and medical procedures
Wound dehiscence
0.00%
0/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
1.0%
2/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
General disorders
4.9%
18/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
11.1%
22/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire

Other adverse events

Other adverse events
Measure
Patients who have selected bladder-sparing therapy
n=371 participants at risk
Patients with a diagnosis of recurrent high-grade NMIBC who have selected bladder-sparing therapy (BST)
Patients who have selected radical cystectomy
n=199 participants at risk
Patients with a diagnosis of recurrent high-grade NMIBC who have selected radical cystectomy (RC)
Renal and urinary disorders
Hematuria
8.6%
32/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
3.0%
6/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Renal and urinary disorders
Urinary tract infection (UTI)
11.1%
41/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
16.1%
32/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Blood and lymphatic system disorders
Anemia
3.2%
12/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
20.1%
40/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
Gastrointestinal disorders
Nausea
3.5%
13/371 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire
10.1%
20/199 • Time frame for all-cause mortality is 12 months post enrollment to match participant flow. Time frame for all other adverse events is 12 months after diagnosis of recurrent high-grade non-muscle invasive bladder cancer, up to 12 months post enrollment.
Adverse event reporting occurred systematically through regular investigator assessment and a standard questionnaire

Additional Information

Dr. John Gore

University of Washington

Phone: 206-543-9926

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place