BOLERO (bladder cancer)

This study compared traditional open cystectomy surgery (removal of the bladder) with keyhole surgery, or robotic surgery, for bladder cancer.

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, but it is a complicated operation and people have to stay in hospital for about three weeks. There are also possible complications, such as wound infection.

We now have the ability to 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 was a feasibility study to find out if people would be willing to take part in a trial comparing the two types of surgery. We hoped to see if patients were willing to take part in such a trial and understand more about what might stop people agreeing to take part. We wanted to learn more about which type of surgery is safest, works best and has fewer complications.


The trial was very important in that it shed light on some of the barriers to recruitment to surgical technology studies.


Many patients also expressed that their choices had been shaped by encounters with their clinical teams. Whilst some patients felt their surgeon favoured the robotic option, others interpreted 'indirect' cues such as the 'established' reputation of the surgeon and surgical method.


In 2017 we plan to open a large Phase III trial which will evaluate robotic surgery further and the results of BOLERO have helped us design the trials which will be called iROC

Read more about BOLERO at Cancer Research UK.


Read the BOLERO publication summary.