BART phase 3: adjuvant pelvic radiotherapy after cystectomy improves locoregional control in high-risk MIBC

Phase 3 RCT · MedPage Today · 2026-10-29. Number 4 in the UrologyWatch Top 5 for October 30, 2026.

In 153 patients with high-risk muscle-invasive bladder cancer after radical cystectomy and chemotherapy, adjuvant pelvic radiotherapy improved 2-year locoregional failure-free survival (87.1% vs 76.0%; HR 0.43). Disease-free and overall survival differences were not statistically significant.

Why it matters: Supports considering adjuvant radiotherapy for selected high-risk patients (e.g., pT3-4 or node-positive disease); without an overall survival benefit, the trade-off is local control against added treatment.

Limitation: Four centers in India; distant recurrence was similar in both arms and secondary endpoints were not significant.

Source: MedPage Today · PubMed 42166701 · DOI 10.1200/jco-25-02093

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