Risk stratification and management of non-muscle-invasive bladder cancer: A physician survey in six Asia-Pacific territories
- Author(s)
- Ku, JH; Lee, LS; Lin, TP; Kikuchi, E; Kitamura, H; Ng, CF; Ng, JYS; Poon, DM; Kanesvaran, R; Seo, HK; Spiteri, C; Tan, EM; Tran, B; Tsai, YS; Nishiyama, H;
- Details
- Publication Year 2024-01,Volume 31,Issue #1,Page 64-71
- Journal Title
- International Journal of Urology
- Publication Type
- Research article
- Abstract
- OBJECTIVES: Multiple clinical practice guidelines, conflicting evidence, and physician perceptions result in variations in risk stratification among patients with non-muscle-invasive bladder cancer (NMIBC). This study aims to describe the extent of this variation and its impact on management approaches in the Asia-Pacific region. METHODS: We conducted a cross-sectional survey involving 32 urologists and seven medical oncologists with ≥8 years of experience managing early-stage bladder cancer patients across Australia, Hong Kong, Japan, South Korea, Singapore, and Taiwan. The physicians completed an anonymous questionnaire that assessed their risk stratification and respective management approaches, based on 19 NMIBC characteristics. For each NMIBC characteristic, they were required to select one risk group, and their most preferred management approach. RESULTS: Our results demonstrated a higher consensus on risk classification versus management approaches. More than 50% of the respondents agreed on the risk classification of all NMIBC characteristics, but 42% or fewer chose the same treatment option as their preferred choice for all but two characteristics-existence of variant histology (55%) and persistent high-grade T1 disease on repeat resection (52%). Across territories, there was the greatest variation in preferred treatment options (i.e., no treatment, intravesical chemotherapy, or Bacillus Calmette-Guérin [BCG] treatment) for intermediate-risk patients and the highest consensus on the treatment of very high-risk patients, namely radical cystectomy. CONCLUSIONS: Our study revealed considerable variation in risk stratification and management of NMIBC in the region. It is critical to develop practical algorithms to facilitate the recognition of NMIBC and standardize the treatment of NMIBC patients.
- Publisher
- Wiley
- Keywords
- Humans; *Non-Muscle Invasive Bladder Neoplasms; Cross-Sectional Studies; *Urinary Bladder Neoplasms/diagnosis/epidemiology/therapy; Administration, Intravesical; Urologists; Surveys and Questionnaires; Risk Assessment; Hong Kong; BCG Vaccine/therapeutic use; Neoplasm Invasiveness; Adjuvants, Immunologic; Neoplasm Recurrence, Local/drug therapy; Nmibc; clinical practice; physician; survey; treatment guidelines
- Department(s)
- Medical Oncology
- Publisher's Version
- https://doi.org/10.1111/iju.15309
- Open Access at Publisher's Site
https://doi.org/10.1111/iju.15309- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-02-20 12:45:01
Last Modified: 2024-02-20 12:45:10