Abstract

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• We examined randomized controlled trials in urologic oncology published in 1992. Particular emphasis was placed on the contribution of urologists and studies with a surgical arm. Randomized controlled trials in bladder, prostate, testis and renal carcinoma were identified by a structured MEDLINE® search. Results were analyzed to determine modality of treatment, disease site, principal author, country of origin, cohort size, number of participating centers, source of funding and type of journal. MEDLINE® retrieved 162 references of which 126 were excluded by title (10), abstracts (105) or articles (11) as not urologic oncology (7) or not a randomized controlled trials (119). Of the qualifying 36 randomized controlled trials, the site of the disease was bladder (44%), prostate (39%) renal (14%) and testis (3%). All except six randomized controlled trials compared medical therapies. Only five had a surgical arm and one had a radiation arm. Cohort size was > 100 in 67% of randomized controlled trials with most (56%) being multicenter trials. Participating countries were Europe, excluding the UK (35%), the US (23%), Japan (20%), Canada (13%), and the UK (10%). Urologists were the principal authors of 67% of the papers describing randomized controlled trials. The majority of trials were published in nonsurgical journals (50%). Funding for randomized controlled trials was from government (28%), pharmaceutical companies (19%), private sources (3%) and not stated (50%). Although randomized controlled trials are being conducted in urologic oncology, there are relatively few compared with trials using inferior study designs. A still smaller proportion of randomized controlled trials contain a surgical arm.