Update on the guideline of guidelines: non‐muscle‐invasive bladder cancer

Taylor, Jacob; Becher, Ezequiel; Steinberg, Gary D.

doi:10.1111/bju.14915

Cited by 76 publications

(59 citation statements)

References 64 publications

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“…Risk factors for recurrence are the number of primary tumors, the university, the degree of infiltration and the recurrence probability (especially whether the recurrence time is within 3 months after the surgery), etc., while pathological grade and stage of tumors are associated with tumor progression [6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Transurethral needle electrode resection and transurethral holmium laser resection of bladder cancer

et al. 2020

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The aim of the present study was to explore the efficacy and safety of transurethral needle electrode resection and transurethral holmium laser resection of non-muscular invasive bladder cancer (NMIBC). Patients and methods: In this prospective, case-control study, patients from the Urinary Surgery or Oncology Department who met the inclusion and exclusion criteria received transurethral needle electrode resection (n = 52) or transurethral holmium laser resection (n = 51). Results: A total of 103 patients with NMIBC were included in the present study, with 68 males and 35 females. Their mean age was 57.3 years. Sixty-two patients had Ta, 15 patients had T1, and 26 patients had Tis. Operative time, intraoperative blood loss, postoperative gross hematuria time, bladder irrigation time, and postoperative hospitalization time were all significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. After resection, transurethral holmium laser resection significantly decreased the value of HGF, TSH, and TNF-α versus the transurethral needle electrode resection group. The incidence of obturator reflex was significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. There was no significant difference in disease-free survival rate and progression-free survival rate between the two groups. Conclusions: Transurethral holmium laser resection has clinical advantages in the treatment of NMIBC.

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Section: Discussionmentioning

confidence: 99%

Transurethral needle electrode resection and transurethral holmium laser resection of bladder cancer

et al. 2020

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“…It is a retrospective cohort study to evaluate the impact of non-compliance to standardized risk-adjusted surveillance and treatment in NMIBC. We have used the EAU risk strati cation and surveillance protocol as a reference which is widely accepted and used in most European centres as we don't have national guidelines [8].…”

Section: Methodsmentioning

confidence: 99%

“…The patients were distributed into three main risk group categories according to the EAU risk strati cation [8]. The largest group was the high-risk group which contains 63 patients (71.5%), while the low and intermediate group entails 25 patients (28.5%); (Table 2B).…”

Section: Demographic and Clinical Presentationmentioning

confidence: 99%

The Impact of Non-compliance to Standardized Risk-adjusted Protocol in Non-Muscle Invasive Bladder Cancer on Recurrence, Progression and Mortality: Lessons to Learn in the Era of COVID-19

Abushamma

Khayyat

Soroghle

et al. 2020

Preprint

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BackgroundNon-Muscle Invasive Bladder Cancer (NMIBC) is potentially curable or a controllable disease if strict adherence to surveillance protocol is followed. Management and surveillance of NMIBC begin at the time of diagnosis up to few years thereafter based on the risk group category. There is scanty data in the literature evaluating the impact of non-compliance to surveillance protocol on progression, recurrence, and mortality rate. We do believe that this data will add to the literature especially during the COVID-19 pandemic which affects and delays daily elective surgeries. MethodsA retrospective study of two hundred bladder biopsy and resection between 2012-2017. Eighty-eight patients with minimal 3 years follow up data were included. Patients were divided into 2 groups based on their compliance with the cystoscopy follow up as recommended by the European guidelines. We compared the cystoscopy compliant group to the non-compliant group in view of recurrence, progression, and mortality. In addition, missing variable items during surveillance are calculated in a new scoring model to predict the adverse outcome. ResultsRecurrence rate (RR), progression rate (PR), metastasis rate (MsR) and mortality rate (MR) are significantly higher in non-compliant group, RR: (92.6%) (P<0.001), PR: (54.1%) (P<0.001), MsR: (37.7%) (P<0.001), MR: (23.5%) (P= 0.002) respectively. In subgroup analysis, intermediate and high-risk groups have a PR rate of zero in the compliant group while it is 100% (P<0.001) and 56.4% (P=0.001) in the non-compliant group respectively. Kaplan Meier (KM) graph shows that compliant patients were more likely to be better than non-compliant. ConclusionsNoncompliance to a standardized surveillance protocol in NMIBC is associated statistically and clinically with adverse outcomes in comparison to a compliant group which mandates strict adherence to surveillance guidelines to improve outcomes in NMIBC.

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“…39,40 Furthermore, all updated recommendations were collected and compared in a new guideline. 41 Recently, the Bladder Cancer Advocacy Network (BCAN) released a joint statement with representatives of different urological societies to also help physicians in the current framework. The consensus of general recommendations to address BCG shortages is described below.…”

Section: Variations In Clinical Guidelines Recommendationsmentioning

confidence: 99%

“…Priming is performed in each trial with Tokyo BCG 31 or RUTI (a therapeutic vaccine for tuberculosis). 41,49 It is worth noting that Ji et al (2019) recently demonstrated the safety of BCG priming in NMIBC patients as well as the different responses of enhanced innate effector cells against some specific BC cell lines, suggesting a potential BCG resistance mechanism that could explain BCG nonresponsivity in some individuals. 50 On the other hand, optimum maintenance schedule has not been clarified.…”

Section: Modification Of Schedules Priming-boosting Strategymentioning

confidence: 99%

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

Guallar-Garrido

Julián

2020

ITT

142

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Physicians treating patients affected by nonmuscle-invasive bladder cancer (NMIBC) have been in shock during the last six years since manufacturing restrictions on the production of the first-option medicine, Mycobacterium bovis Bacillus Calmette-Guérin (BCG), have resulted in worldwide shortages. This shortage of BCG has led to a rethinking of the established treatment guidelines for the rationing of the administration of BCG. Some possible schedule modifications consist of a decrease in the length of maintenance treatment, a reduction in the dose of BCG in intravesical instillations or the use of different BCG substrains. All these strategies have been considered valuable in times of BCG shortage. In addition, the lack of availability of BCG has also led to the general recognition of the need to find new treatment options for these patients so that they are not dependent on a single treatment. Few alternatives are committed to definitively replacing BCG intravesical instillations, but several options are being evaluated to improve its efficacy or to combine it with other chemotherapeutic or immunotherapeutic options that can also improve its effect. In this article, we review the current state of the treatment with BCG in terms of all of the aforementioned aspects.

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Update on the guideline of guidelines: non‐muscle‐invasive bladder cancer

Cited by 76 publications

References 64 publications

Transurethral needle electrode resection and transurethral holmium laser resection of bladder cancer

Transurethral needle electrode resection and transurethral holmium laser resection of bladder cancer

The Impact of Non-compliance to Standardized Risk-adjusted Protocol in Non-Muscle Invasive Bladder Cancer on Recurrence, Progression and Mortality: Lessons to Learn in the Era of COVID-19

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

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