A trial looking at different types of surgery for bladder cancer (BOLERO)

Please note - this trial is no longer recruiting patients. We hope to add results when they are available.

Cancer type:

Bladder cancer




Phase 2

This study is being done to see if it will be possible to recruit enough people to a larger trial comparing open surgery with keyhole surgery for bladder cancer. This trial is supported by Cancer Research UK.

If you have bladder cancer, your doctors may suggest you have an operation to remove the bladder. This is called an open radical cystectomy and is a standard treatment Open a glossary item. But it is a complicated operation and people have to stay in hospital for about 3 weeks. And there are possible complications, such as wound infection.

Surgeons at many UK hospitals can now remove the bladder in a different way using a type of keyhole surgery called laparoscopic or robotic cystectomy. But we don’t yet know which type of surgery is best for people with bladder cancer

This is a feasibility study to find out if people would be willing to take part in a trial comparing the 2 types of surgery.

The aims of the feasibility study are to

  • See if patients are willing to take part in a trial comparing open cystectomy with keyhole surgery for bladder cancer
  • Understand more about what might stop people agreeing to take part
  • Learn more about which type of surgery is safest, works best and has fewer complications
  • Find out how each type of surgery affects quality of life Open a glossary item

Who can enter

You can enter this trial if you

  • Have been diagnosed with bladder cancer that is stage Ta, T1, T2 or T3
  • Are well enough to have a general anaesthetic Open a glossary item
  • Are at least 18 years old

If you have chemotherapy before surgery, you must have finished this treatment at least 3 weeks ago, but no more than 10 weeks ago.

You cannot enter this trial if you

  • Have any enlarged lymph nodes Open a glossary item or a scan shows that the cancer has spread somewhere else
  • Have cancer affecting the upper part of your urinary tract
  • Have a severe infection of the urinary tract that has spread to your bloodstream (urosepsis)
  • Have any other medical condition that could affect you taking part in this study
  • Are pregnant or breastfeeding

Trial design

This is called a feasibility study. It aims to recruit about 72 people from up to 20 hospitals in the UK. If this study shows that people are willing to take part in a trial comparing the 2 types of surgery, the researchers will carry out a larger phase 3 trial to learn more.

The study is randomised so the people taking part are put into treatment groups by a computer. Neither you nor your doctor will be able to decide which group you are in.

  • People in group A have an open radical cystectomy
  • People in group B have keyhole surgery

Everybody taking part will also be asked to fill out 2 questionnaires when they join the trial, and then after 4 weeks, 6 weeks, 8 weeks, 3 months and 6 months. The questionnaires will ask about any side effects you have had and about how you have been feeling. This is called a quality of life study.

The trial team will also ask your permission to take some samples of cancer tissue removed when you have surgery. And they will ask for extra blood and urine samples. The researchers will study these samples to learn more about bladder cancer. If you don’t want to give these samples for research you don’t have to. You can still take part in the trial.

If you decide that you don’t want to take part in the main trial, the trial team may ask if you would be willing to take part in a sub study. This aims to get a better understanding of the reasons why people decide not to take part in a trial. You don’t have to take part in this sub study if you don’t want to.

If you do agree to take part, you will have a short interview with a researcher at a time that is convenient for you. This may be at the hospital or in your home. The interview will last between 30 minutes and an hour and the researcher will make an audio recording of it. All the information collected is confidential Open a glossary item and it will not be possible to identify you in any results.

Hospital visits

You will see the doctors and have some tests before you start treatment. The tests include

  • Physical examination
  • Blood and urine tests
  • CT scan

The length of time you stay in hospital will vary depending on how quickly you recover after surgery. But you are likely to be in hospital for at least a week.

The trial team will look at your medical notes from your time in hospital to see

  • What painkillers you needed
  • How quickly after your operation you started eating and drinking
  • How long it was before you were up and about
  • When you went home
  • If you had complications such as problems with your wound or if you needed to have any blood transfusions

You will go back to hospital to see the trial team about 6 weeks after surgery, and then 3 months and 6 months later.

Side effects

Your surgeon will discuss the operation with you in detail and explain exactly what the surgery will involve and what to expect afterwards. There is more information about surgery for invasive bladder cancer on CancerHelp UK.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor John Kelly

Supported by

Cancer Research UK
Cardiff University
University College Hospital

Other information

This is Cancer Research UK trial number CRUK/08/036.

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle 3355

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Over 60,000 cancer patients enrolled on clinical trials in the UK last year.

Last reviewed:

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