scholarly journals Management of Non-Muscle-invasive Bladder Cancer: Quality of Clinical Practice Guidelines and Variations in Recommendations

2019 ◽  
Author(s):  
Jing Zhang ◽  
Yunyun Wang ◽  
Hong Weng ◽  
Danqi Wang ◽  
Fei Han ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Bladder Tumour ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
The Past ◽  
Muscle Invasive

Abstract Abstract Background: Bladder cancer (BC) has become a major worldwide public health issue, especially non-muscle-invasive bladder cancer (NMIBC). A flood of related clinical practice guidelines (CPGs) have emerged; however, the quality and recommendations of the guidelines are controversial. We aimed to appraise the quality of the CPGs for NMIBC within the past 5 years and compare the similarities and differences between recommendations for therapies. Methods: A systematic search to identify CPGs for NMIBC was performed using electronic databases (including PubMed, Embase, Web of Science), guideline development organizations, and professional societies from January 12, 2014 to January 12, 2019. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was performed to assess the overall agreement among reviewers. Results: Nine CPGs were included. The overall agreement among reviewers was excellent. The interquartile range (IQR) of scores for each domain were as follows: scope and purpose 69.44% (35.42%, 85.42%); stakeholder involvement 41.67% (30.56%, 75.00%); rigour of development 48.96% (27.08%, 65.63%); clarity and presentation 80.56% (75.00%, 86.11%); applicability 34.38% (22.92%, 40.63%) and editorial independence 70.83% (35.42%, 85.42%). The NICE, AUA, EAU and CRHA/CPAM clinical practice guidelines consistently scored well in most domains. It was generally accepted that the transurethral resection of bladder tumour (TURBT) and intravesical chemotherapy should be performed in the management of bladder cancer. The application of chemotherapy was highly controversial in high risk NMIBC. The courses of BCG maintenance were similar and included 3 years of therapy at full maintenance doses. Conclusions: The quality of NMIBC guidelines within the past 5 years varied, especially regarding stakeholders, rigour and applicability. Despite many similarities, the recommendations had some inconsistencies in the details.

scholarly journals Management of non-muscle-invasive bladder cancer: quality of clinical practice guidelines and variations in recommendations

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jing Zhang ◽  
Yunyun Wang ◽  
Hong Weng ◽  
Danqi Wang ◽  
Fei Han ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Bladder Tumour ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
The Past ◽  
Muscle Invasive

Abstract Background Bladder cancer (BC) has become a major worldwide public health issue, especially non-muscle-invasive bladder cancer (NMIBC). A flood of related clinical practice guidelines (CPGs) have emerged; however, the quality and recommendations of the guidelines are controversial. We aimed to appraise the quality of the CPGs for NMIBC within the past 5 years and compare the similarities and differences between recommendations for therapies. Methods A systematic search to identify CPGs for NMIBC was performed using electronic databases (including PubMed, Embase, Web of Science), guideline development organizations, and professional societies from January 12, 2014 to January 12, 2019. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was performed to assess the overall agreement among reviewers. Results Nine CPGs were included. The overall agreement among reviewers was excellent. The interquartile range (IQR) of scores for each domain were as follows: scope and purpose 69.44% (35.42, 85.42%); stakeholder involvement 41.67% (30.56, 75.00%); rigour of development 48.96% (27.08, 65.63%); clarity and presentation 80.56% (75.00, 86.11%); applicability 34.38% (22.92, 40.63%) and editorial independence 70.83% (35.42, 85.42%). The NICE, AUA, EAU and CRHA/CPAM clinical practice guidelines consistently scored well in most domains. It was generally accepted that the transurethral resection of bladder tumour (TURBT) and intravesical chemotherapy should be performed in the management of bladder cancer. The application of chemotherapy was highly controversial in high risk NMIBC. The courses of BCG maintenance were similar and included 3 years of therapy at full maintenance doses. Conclusions The quality of NMIBC guidelines within the past 5 years varied, especially regarding stakeholders, rigour and applicability. Despite many similarities, the recommendations had some inconsistencies in the details.

scholarly journals Management of Non-Muscle-invasive Bladder Cancer: Quality of Clinical Practice Guidelines and Variations in Recommendations

2019 ◽  
Author(s):  
Jing Zhang ◽  
Yunyun Wang ◽  
Hong Weng ◽  
Danqi Wang ◽  
Fei Han ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Bladder Tumour ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
The Past ◽  
Muscle Invasive

Abstract Background: Bladder cancer (BC) has become a major worldwide public health issue, especially non-muscle-invasive bladder cancer (NMIBC). A flood of related clinical practice guidelines (CPGs) have emerged; however, the quality and recommendations of the guidelines are controversial. We aimed to appraise the quality of the CPGs for NMIBC within the past 5 years and compare the similarities and differences between recommendations for therapies. Methods: A systematic search to identify CPGs for NMIBC was performed using electronic databases (including PubMed, Embase, Web of Science), guideline development organizations, and professional societies from January 12, 2014 to January 12, 2019. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was performed to assess the overall agreement among reviewers. Results: Nine CPGs were included. The overall agreement among reviewers was excellent. The interquartile range (IQR) of scores for each domain were as follows: scope and purpose 69.44% (35.42%, 85.42%); stakeholder involvement 41.67% (30.56%, 75.00%); rigour of development 48.96% (27.08%, 65.63%); clarity and presentation 80.56% (75.00%, 86.11%); applicability 34.38% (22.92%, 40.63%) and editorial independence 70.83% (35.42%, 85.42%). The NICE, AUA, EAU and CRHA/CPAM clinical practice guidelines consistently scored well in most domains. It was generally accepted that the transurethral resection of bladder tumour (TURBT) and intravesical chemotherapy should be performed in the management of bladder cancer. The application of chemotherapy was highly controversial in high risk NMIBC. The courses of BCG maintenance were similar and included 3 years of therapy at full maintenance doses. Conclusions: The quality of NMIBC guidelines within the past 5 years varied, especially regarding stakeholders, rigour and applicability. Despite many similarities, the recommendations had some inconsistencies in the details.

scholarly journals Management of Non-Muscle-invasive Bladder Cancer: Quality of Clinical Practice Guidelines and Variations in Recommendations

2019 ◽  
Author(s):  
Jing Zhang ◽  
Yunyun Wang ◽  
Hong Weng ◽  
Danqi Wang ◽  
Fei Han ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Bladder Tumour ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
The Past ◽  
Muscle Invasive

Abstract Background: Bladder cancer (BC) has become a major worldwide public health issue, especially non-muscle-invasive bladder cancer (NMIBC). A flood of related clinical practice guidelines (CPGs) have emerged; however, the quality and recommendations of the guidelines are controversial. We aimed to appraise the quality of the CPGs for NMIBC within the past 5 years and compare the similarities and differences between recommendations for therapies. Methods: A systematic search to identify CPGs for NMIBC was performed using electronic databases (including PubMed, Embase, Web of Science), guideline development organizations, and professional societies from January 12, 2014 to January 12, 2019. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was performed to assess the overall agreement among reviewers. Results: Nine CPGs were included. The overall agreement among reviewers was excellent. The interquartile range (IQR) of scores for each domain were as follows: scope and purpose 69.44% (35.42%, 85.42%); stakeholder involvement 41.67% (30.56%, 75.00%); rigour of development 48.96% (27.08%, 65.63%); clarity and presentation 80.56% (75.00%, 86.11%); applicability 34.38% (22.92%, 40.63%) and editorial independence 70.83% (35.42%, 85.42%). The NICE, AUA, EAU and CRHA/CPAM clinical practice guidelines consistently scored well in most domains. It was generally accepted that the transurethral resection of bladder tumour (TURBT) and intravesical chemotherapy should be performed in the management of bladder cancer. The application of chemotherapy was highly controversial in high risk NMIBC. The courses of BCG maintenance were similar and included 3 years of therapy at full maintenance doses. Conclusions: The quality of NMIBC guidelines within the past 5 years varied, especially regarding stakeholders, rigour and applicability. Despite many similarities, the recommendations had some inconsistencies in the details.

The Influence of Access Related Factors on Adherence to Clinical Practice Guidelines for Muscle Invasive Bladder Cancer

2014 ◽  
Vol 1 (3) ◽  
pp. 127-133 ◽  
Author(s):  
C.J. Stimson ◽  
Matthew J. Resnick ◽  
Sanjay G. Patel ◽  
Harras B. Zaid ◽  
Michael S. Cookson ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Related Factors ◽  
Muscle Invasive

scholarly journals Organ-saving treatment of invasive bladder cancer

2013 ◽  
Vol 94 (4) ◽  
pp. 501-505
Author(s):  
M E Sitdykova ◽  
A Y Zubkov ◽  
I R Nuriev
Keyword(s):  
Bladder Cancer ◽  
Standard Treatment ◽  
Social Adaptation ◽  
Invasive Bladder Cancer ◽  
Surgical Trauma ◽  
Muscle Invasive Bladder Cancer ◽  
The Past ◽  
Urological Malignancies ◽  
Muscle Invasive

The review describes the modern approaches to open and endoscopic surgery, chemo- and radiotherapy in organ-saving treatment of invasive bladder cancer. Bladder cancer nowadays ranks the second among urological malignancies. Incidence of bladder cancer in Russia has increased by 58.6% over the past 10 years, with the share of invasive tumors reaching 30%. According to the European Association of Urology guidelines, the radical cystectomy with ureterocolonic diversion is the standard treatment of muscle-invasive bladder cancer. However, the extensive surgical trauma, comorbidities and exhaustion of patients, disability and social adaptation failure as well as the high mortality rate restrict the use of cystectomy. Thereby, taking into account the dynamic development of chemo- and radiotherapy allowing to reduce the recurrence rate, more and more experts are inclined to use organ-saving treatment of invasive bladder cancer. Organ-saving treatment has several advantages: it is less complicated and costly, preserves sexual function, decreases the risk of kidney damage and provides a good quality of life. Still, scanty publications are comparing results of cystectomy and organ-saving treatments of invasive bladder cancer, causing controversial opinions and highlighting the need for further studies.

scholarly journals 377 Global Recruitment for The RESECT Study (Transurethral Resection and Single-Instillation Intravesical Chemotherapy Evaluation in Bladder Cancer Treatment): An International Observational Cohort Study Aiming to Improve the Quality of Surgery for Non-Muscle Invasive Bladder Cancer

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Light ◽  
K Gallagher ◽  
N Bhatt ◽  
K Clement ◽  
M a Kulkarni ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Statistical Power ◽  
Bladder Tumour ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Mailing Lists ◽  
Quality Of Surgery ◽  
Muscle Invasive

Abstract Introduction Non-muscle invasive bladder cancer (NMIBC) can be curatively treated with ‘good quality’ transurethral resection of the bladder tumour (TURBT). However, despite evidence-based international guidelines, there is anecdotal evidence that practice varies widely, and this may affect oncological outcomes. Launching in 2020, RESECT aims to measure and report variation in TURBT quality globally, and determine if outcome reporting improves outcomes. Method RESECT was advertised internationally through social media, mailing lists, websites, and in person. Collaborators at each registered site will collect data about current practice and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators. Results As of August 27, 508 collaborators have registered to participate. Collaborators represent 321 centres from 54 countries, with the highest number from the United Kingdom (54.5%), Spain (5.9%), and Argentina (3.7%). 51.2% are trainees, 29.9% consultants, and 17.5% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power. Conclusions RESECT has attracted a large number of collaborators globally and from all training levels. Therefore, the RESECT study has the potential to improve the quality of TURBT surgery across the world.

scholarly journals Prediction of histological stage based on cystoscopic appearances of newly diagnosed bladder tumours

2016 ◽  
Vol 98 (8) ◽  
pp. 547-551 ◽  
Author(s):  
VA During ◽  
GM Sole ◽  
AK Jha ◽  
JA Anderson ◽  
RT Bryan
Keyword(s):  
Bladder Cancer ◽  
Predictive Value ◽  
Bladder Tumour ◽  
Visual Assessment ◽  
Invasive Bladder Cancer ◽  
Newly Diagnosed ◽  
Muscle Invasive Bladder Cancer ◽  
Cross Sectional ◽  
Radiological Staging ◽  
Muscle Invasive

INTRODUCTION In the 75–80% of urothelial bladder cancers (UBC) presenting as non-muscle invasive bladder cancer (NMIBC), transurethral resection of bladder tumour (TURBT) is the key treatment and staging procedure. In the 20–25% of patients with muscle invasive bladder cancer (MIBC), further cross-sectional imaging is required to complete the staging process before considering radical treatment. Given the adverse effects of ionising radiation, clinicians identify patients believed to have MIBC, and so requiring further imaging pre-TURBT, at the tumour histology/stage based on the tumour’s visual characteristics. There is minimal evidence describing the accuracy of such predictions in newly-diagnosed patients. METHODS Over a 6-year period, a database of patients undergoing resection of newly-diagnosed bladder lesions in a single UK centre was prospectively established. Predictions based on histology were simultaneously recorded, and the accuracy of these predictions of histology/stage subsequently assessed. RESULTS One hundred and twenty two (73.1%) patients with histologically confirmed NMIBC had predictions recorded versus 45 (26.9%) patients with MIBC. Visual assessment predictions of MIBC had a sensitivity of 88.9% (95% confidence interval [CI] 76.5%–95.2%) and a specificity of 91.0% (95% CI 84.6%–94.9%), giving a positive predictive value of 78.4% (95% CI 65.4%–87.5%) and a negative predictive value of 95.7% (95% CI 90.3%–98.1%). CONCLUSIONS We find that visual assessment is accurate in predicting the presence of MIBC. This supports the practice of stratifying patients at the time of initial cystoscopy for those requiring further radiological staging pre-TURBT.

scholarly journals Recurrence and progression of non-muscle invasive bladder cancer following trans-urethral resection of bladder tumour with adjuvant intravesical chemo-immunotherapy

2020 ◽  
Vol 10 (3) ◽  
pp. 34-38
Author(s):  
Ashok Kumar Kunwar ◽  
Kabir Tiwari ◽  
Sanjesh Bhakta Shrestha ◽  
Srijana Thapa ◽  
Ashish Kumar Panthee ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Effective Treatment ◽  
Risk Group ◽  
Bladder Tumour ◽  
Low Risk ◽  
Invasive Bladder Cancer ◽  
Intermediate Risk ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Background: Trans-urethral resection of bladder tumor is an essential diagnostic tool as well as effective treatment modality for non-muscle invasive bladder cancer. We aimed to evaluate the recurrence and progression of the non-muscle invasive bladder cancer in Nepalese patients. Methods: This was a retrospective study of 43 patients with non-muscle invasive bladder cancer, who underwent trans-urethral resection of bladder tumour followed by adjuvant intravesical instilla­tion of chemo or immunotherapy between January, 2013 to December, 2018. Patients were divided into low, intermediate and high-risk groups according to the clinical and pathological factors used by the European Organization for Research and Treatment of Cancer scoring system. Outcomes were calculated in terms of recurrence and progression in each group. Results: Out of 43 patients, 11 (25.58%) patients had low risk, 18 (41.86%) patients had intermediate risk and 14 (32.56%) patients had high risk of recurrence categories. No recurrence and progression of the disease noted in low risk group. In the intermediate risk group, out of 18 patients, 4 (22.2%) patients developed recurrence and 2 (11.1%) patients had progression of disease. In high risk group, out of 14 patients, 4 (26.8%) patients developed recurrence and 2 (14%) patients developed progres­sion of the disease. Conclusions: Even in a low volume centre of bladder cancer, effective treatment for non-muscle inva­sive bladder cancer with trans-urethral resection of bladder tumour followed by adjuvant intravesical chemo or immunotherapy can be given safely to reduce recurrence and progression of the disease.

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